“Okay, let’s crack him.”
Let’s crack him—three simple words that sent a shock wave through the ER. Three words that invited every surgery resident, internal medicine resident, medical student, respiratory therapist, lab tech, blood gas tech—and even the housekeeping staff—to flood into the room, hoping to witness the most dramatic procedure, the greatest spectacle, in all of medicine.
Hacker shed his white coat, threw on sterile gloves, and grabbed a scalpel as a nurse doused the patient’s chest with Betadine solution. With one long swipe, Hacker sliced through skin and muscle from the left side of the sternum to the left shoulder blade. The tissues barely bled. With a second swipe he entered the chest cavity. He placed a rib spreader and cranked it open. Ribs crunched and snapped. The lung billowed out of the incision like a pink balloon, inflating and deflating as the respiratory therapist squeezed and released the bag. Hacker stuck one hand deep inside the thorax, and with the other, guided a vascular clamp to the same spot and snapped it closed. “The aorta’s cross-clamped,” he said.
With a pair of scissors, he opened the pericardial sac and exposed the heart. It was dark blue and quivering like a sack of worms—the hallmark of ventricular fibrillation. He squeezed it between his palms in a rhythmic fashion.
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