The incoming ambulance was our signal--a call to arms for me and several nurses to be ready at the ER entrance. Fifteen minutes earlier, a distress call had reported a man in his fifties suffering from chest pain and shortness of breath lasting over twenty minutes.
"What are you feeling, sir?" I asked gently as I examined him.
"Please, doctor, help my husband," his wife cried, her voice cracking into sobs. "He said it hurts... that he felt like he was dying."
I steadied myself, refusing to be swept away by emotion. This kind of chaos was no stranger to me, but to a family, it would always feel like the end of the world. As a doctor, calm must be my shield. After all, heart attacks are not rare--they are the leading cause of death in Indonesia. In the world.
"Please stay calm for now, ma'am. We'll begin the examination. Have you registered?"
"No, not yet, doctor."
"Please head to registration. We'll continue once that's done."
I turned my focus back to the patient's intake form--verifying identity, briefly scanning the symptoms. Today was restless. A major traffic accident at the ring road intersection had flooded the ER with critical cases--a truck and a small car. It was clear I wouldn't be tending to just one patient tonight.
After I completed the initial assessment, I nodded to Senior Nurse Nate, who swiftly wrapped the blood pressure cuff around the man's arm. Once the form was filled, the two of us wheeled the gurney toward the red triage corridor.
"Nurse Nate, I'll leave the rest to you," I said, heading off toward the next patient as he fitted the oxygen mask, attached the bedside monitor, and affixed the pulse oximeter to the man's chest.
Was I exhausted? Of course. I didn't need a gym to shed weight--just skipping meals at this pace did the job. Not that I skipped them on purpose; there simply wasn't time.
Only minutes after I left that patient, the shrill blare of a code blue siren tore through the ER. I sprinted toward the sound.
Nurse Nate was already there, hands pressing rhythmically against the man's chest in CPR. Beside him, Nurse Stella and I rushed in with the defibrillator.
"Ventilation, Nurse Stella," I instructed, and she placed the ambu bag over the patient's mouth, gently pumping it with calm, steady motions.
"Check pulse?" I asked as Nurse Nate paused.
"No pulse," he replied, solemn.
No pulse--confirmation that the heart had stopped. I glanced at the monitor. Jagged lines. Chaotic. Ventricular fibrillation.
"Prepare defibrillation--200 joules," I ordered.
"200 joules ready."
"Gel," I said, and Nurse Stella squeezed the electrolyte jelly onto the paddles.
"Shock is ready. I'm clear, you're clear? Everyone clear?"
"Clear."
"Shock!"
I watched the monitor. Still no sign of asystole.
"Continue CPR--five cycles. Add 1 milligram IV epinephrine, now."
Nurse Stella administered the injection swiftly. In moments like these, multiple rounds of defibrillation could be necessary. The patient's pulse was frighteningly weak.
"Check pulse?"
"No palpable pulse," Nate answered.
"Ventricular fibrillation rhythm, no pulse. Shockable. Prepare 200 joules DC."
"200 joules ready."
"Shock is ready. I'm clear, you're clear. Everybody clear?"
No sign yet of the VF/VT rhythm shifting to asystole.
"Prepare for ETT placement. Continue CPR."
Nurse Stella swiftly assisted me in the endotracheal intubation--a technique used to secure airway and deliver oxygen. My fingers moves with muscle memory, tilting the patient's head slightly back. Carefully, I slid the laryngoscope in, then threaded the tracheal tube down into the throat's passage.
"Check pulse?" I asked again.
"Not palpable," came the answer.
"Switch the ventilator compressor. Request another 200 joules."
Again, I delivered defibrillation, hoping the heart rhythm would return. This is the kind of moment where surrender is not an option. CPR must be repeated again and again until the unmistakable signs of death appear--livor mortis, rigor mortis, decomposition. Until then, the heart demands we fight for every beat.
You've seen it in dramas--rescuers drenched in sweat, rotating in and out just to keep going. It's not fiction. It's the reality of resuscitation.
"ROSC," Nurse Nate called out suddenly--return of spontaneous circulation.
"Check the pulse, check breathing," I said, signaling the end of the emergency cardiac arrest protocol.
Both Stella and Nate exhaled in relief. "Pulse is back. Breathing present."
I closed my eyes briefly and let out a long breath of my own. "Please request an ECG record," I murmured, heading toward the pantry for a moment of rest.
God, I didn't know what cursed words had been spoken today that made everything this intense. Did someone whisper the forbidden phrase--'Why is the ER so quiet today?' That wasn't a mere myth born from medical dramas. It was very real here.
Everyone knew it was a jinx. And yet, somehow it always slipped out--like fate teasing us.
"You have the evening shift today?" asked Robbie, another ER general practitioner.
I shook my head. "Covering for Hector."
Robbie frowned. "Why do you keep playing errand girl for that guy?"
I gave a think smile and sipped from my glass. "The pay's decent. Other hospitals only offer a bit. With him, I name my price based on how tough the case is."
"You've got another shift tonight? Isn't your body gonna get wrecked?"
I sighed--though not because of fatigue. It was because I needed to keep myself busy. Because my mind wouldn't stop spinning with the words of a strange man from last night.
Maybe my ears were playing tricks on me. Or maybe my brain just processed it all wrong.
"Mmm... no, just until nine."
"Huh? You're nuts."
"I only took two shifts, not a full twenty-four hours."
If it weren't for Ronald, I wouldn't be grinding myself into dust like this. Even after today's chaos, his absurd words refused to leave my head.
"Come back with me later. I want to try that viral ramen together with you."
I nodded, flipping open the phone I hadn't touched all day. I hadn't had a moment to spare.
"Sure. I've been craving something spicy anyway."
+628xxxxx
What time is your shift over?
Still working?
I'm waiting in front of theER
I frowned at the message from an unknown number. What's more--it came through old-fashioned SMS, not WhatsApp. Who even uses manual texts anymore?
"Are there still people who uses SMS?" I asked Robbie.
She blinked in confusion. "Probably phishing or something. Just ignore it."
I shrugged and shut off my phone again. Yeah, she was right. Just another scam. These days, it's not surprise that strangers somehow get hold of your number. So much for personal data protection.
I buried myself in work again, staying focused until my shift came to an end. Thankfully, there weren't many new emergency cases tonight. Most of my time was spent monitoring critical patients and transferring them to specialists when needed.
"Let's head out," said Robbie, already dressed in her casual clothes. Normally, we'd go home still wearing our scrubs--not out of pride, but pure laziness and the urge to collapse in bed. But since we were planning to eat at a pretty popular spot, we actually took the time to change.
I nodded and followed her lead. We chatted casually as we walked, until she suddenly said something that made me stop in my tracks.
"Wait... is that Doctor Ronald?"
My heart stuttered.
No joke--I might need DC shock to reset my rhythm. "W-what?"
Robbie glanced toward the ER sign where Ronald was standing, holding what looked like a cup of coffee.
"You know him?" I asked.
Robbie was technically my junior, even if we graduated from the same university--which was also Ronald's alma mater. Still, it felt strange that she would know him.
She scoffed. "Please. Who doesn't know him? Female doctors are lining up to be matched with him. If I didn't have a boyfriend, I'd want to be his wife too. Handsome, powerful, and charismatic--there are only two single men like that in Indonesia, you know."
I raised both brows, "Who?"
"Nicholas Saputra and Ronald Hamilton," She replied with a satisfied grin. "So really, who wouldn't be into him?"
Suddenly, a thought hit me. That message earlier...
I quickly pulled out my phone, comparing the unknown number to the last incoming call. Damn. This wasn't a scam. It was his number.
He had texted me at 7 pm.
Had he really been standing outside the ER for two hours, waiting? For what?
Before I knew it, my feet were moving--closing the space between us until only two meters stood between me and Ronald. That was more than close enough for him to recognize me.
Wait, I wasn't ready to face him.
Panic bubbled up. I grabbed Robbie's arm, tugging it gently. "Robbie... let's go."
"You're done for the day?"
His voice.
I froze.
Every nerve in my body stiffened, as if paralyzed by a stroke. Oh no. Don't tell me I just marched myself into the ER.
Robbie fell silent too, watching me stiffen like a statue. She started to turn around, but I quickly stopped her.
"Don't look!" I whispered.
"Huh?" she asked.
"Just stay still. Walk forward. Whatever you do, don't turn around," I ordered, gripping her hand tighter.
"But the ER exit is back there. Why are we--"
"Shhh, trust me--"
"Where are you headed?"
Shit.
Can't he pretend not to see me? I squeezed my eyes shut in frustration. I didn't even know why I was acting like this.
I just wasn't ready to see him. Not after everything that happened. Not after the foolish things I'd said.
"Alina? That's you, isn't it?" he asked again.
Robbie ignored my warning. Her hand stayed in mine, but her head had already turned toward Ronald.
"Doctor Ronald? What are you doing here?" she asked.
I had no choice but to follow her movement. No way was I going to keep my back turned to him.
"Waiting for Alina."
Cough cough cough.
I faked a cough, trying desperately to drown out his reply.
"Oh! Doctor Ronald--you're here to talk about Alima's leg surgery, right? God, I completely forgot," I said, stepping forward quickly.
I didn't even know what I was doing anymore. I just knew I wanted Ronald to leave.
"Robbie, I'm so sorry--I can't go get ramen tonight. You know my twin, Alima, just had surgery, and it was Doctor Ronald who operated on her. So I really have to get all the post-op details straight--family doctor duties, you know?"
The truth was, Alima's surgery had been a year ago--with no complications, no lingering effects. She was perfectly healthy now, even pregnant with her first child.
"Come one, Doctor. You came here to talk to me, didn't you?" I said, stepping ahead of Ronald, who stood frozen--staring at me as if I'd just rewritten the script of his evening.
********************
Side note:
* ECG (Electrocardiography): a recording of the heart's electrical activity through repeating cardiac cycles.
* Ambu bag ventilation: A technique used to restore breathing in patients who are not breathing spontaneously.
* ETT (Endotracheal Tube): Intubation procedure involving the insertion of an artificial airway tube into the trachea through the mouth.
* VF (Ventricular Fibrillation): A condition where the heart chambers only quiver and fail to pump blood effectively to the body.
* CPR (Cardiopulmonary Resuscitation): First aid administered to a person experiencing cardiac arrest.
* Red Triage: The highest priority classification for patients in critical (life-threatening) condition, requiring immediate medical intervention.
* ROSC (Return of Spontaneous Circulation): The resumption of consistent heart perfusion activity associated with meaningful respiratory effort after cardiac arrest.