I think one of the most exhilarating moments of my medical life occured last night on trauma call. Without going into too much detail (to protect patient confidentiality), here it is:

Around 2 a.m., the call went out on the paging system: "Code III trauma, by ground, stab to chest, combative, vital signs unknown, airway patent." We all shuffled to the trauma bay and gowned up. As the patient rolled in the door, we could tell he was in shock: he was grunting, weakly moving his arms and legs, not responding to questions, with a single stab wound to the left of his sternum. I put an ultrasound probe on his chest and saw the fluid around his heart, a critical condition known as pericardial tamponade. Shortly after intubating him and putting in a large-bore central venous line, he lost his pulse. We rolled straight to the operating room, prepped, gowned, and after a midline chest incision, sawed through his sternum. Opening the sac around his heart, dark blood and clot poured out, and the heart started beating. A single hole in the right ventricle spurted blood into the air, and I put my finger in it to control the bleeding while the attending worked to improve our exposure. A couple of sutures later, all was dry. About that time, the thoracic fellow walked in the OR (we had him paged at home). Without a lot left for him to do, he helped me close the chest, which is harder than it sounds! The best part is, I went back and saw the patient in the ICU later, and he was awake and writing notes on a pad (he was still intubated and couldn't talk, unlike in the movies).

An incredible, once-in-a-residency kind of experience. All of this couldn't have happened without the support of the anaesthesia team, the surgical scrubs and circulators, my attending with ice water in his veins... My job never gets old, that's for sure.