In the past year, I was hospitalized several times, being admitted through the Emergency Room. These ER experiences always remind me of Joyce, who I met when she was in charge of the Johns Hopkins Hospital Emergency Room (previously, she worked in orthopedic surgery). Joyce was well known at Hopkins for running a “tight shop”
Hopkins served as the source of medical care for most residents of the East Baltimore community. Many of these individuals waited until they were very ill before coming to the ER. Medical interns and residents (like myself) were assigned to the ER but it was up to experienced nurses, like Joyce, to meet the ambulance and to make sure those patients who truly needed emergency care (heart attacks, gunshot wounds etc) were treated first. The process is called triage and making the right decision was often a matter of life or death!
One evening in 1960, a patient was brought to the ER with no detectable pulse and ordinarily would simply be pronounced dead. This time, the nurse performing triage remembered that Joyce had informed all the ER nurses that a new method had been developed for resuscitating such patients. The triage nurse, remembering what Joyce had taught her, noted that this man (about 40 yrs old) had indeed suffered cardiac arrest but was still warm, indicating that the event had happened very recently.
She immediately notified the two interns on duty that evening who happened to be Victor Marder and myself. All medical interns and residents had been instructed in this novel procedure, developed by a Hopkins surgeon, for resuscitating individuals after cardiac arrest. This so-called CPR involved a combination of closed chest massage to keep the heart pumping, simultaneously blowing air into the patient’s mouse to provide oxygen and a direct current shock administered with a giant wooden paddle. That night, nurses and physicians worked together to conduct this procedure which was successful (!) and this first CPR was written up in medical journals.
Subsequently, physicians worldwide adopted the technique. The patient who was saved went back to his job and came to Hopkins 25 years later to report that the effect was long lasting and to thank those in the ER that night for saving his life!. Credit goes to Joyce's alert nurses and physicians alike
Arthur