My Lesson about Failure – ACLS

My lesson about failure happens to be in the medical field, but the moral to the story will apply to everything in life.

I reminisce back when the oral surgeon I worked for advised me to take a course called Advanced Cardiac Life Support. This is a course mainly geared towards EMT’s, paramedics, nurses, and doctors. I am a dental assistant. I studied the heart rythyms. All I heard in my sleep was tachycardia, SVT, bradychardia, AV blocks, PEA, you name it. I know most of you won’t understand what any of this means, and that’s alright. You’ll learn just like I did, it wasn’t the reason why he sent me to take the course.

A day before the course I went into my boss’s office and told him I can’t do it. He said “Why?”
I replied “I’m not a doctor. Or a nurse. I don’t know any of this shit. I’m going to embarrass myself.”
He laughed and said, “Who cares?”
“Me”, I said. “I don’t want to look foolish.”
He looked me in my eyes and said “You. You have nothing to lose. The worst thing that is going to come of this, is that you come back here knowing more than you did before. You’re going to go to this course, you’re going to learn, and you’re going to pass.”

I showed up to the hospital the next day. I entered the classroom and everyone around me looked very important. The first thing our instructor did was have everybody introduce themselves and their title. I had the pleasure of going last.
I sat there anxiously waiting for my turn, and as every doctor, nurse, and physicians assistant introduced themselves and told the class where they graduated from, I began shrinking. I swear I shrank so small that I almost started to feel like a fly on the wall. Finally, it was my turn to introduce myself. “I’m Matt, and I’m a dental assistant.”
A couple people smiled. You could tell everyone was looking at me like, “What the hell are you doing here?” At this point I shrunk so small I was wondering the same thing. But the words and the confidence of my boss echoed through my mind, and I promised myself I would prove all those doctors, nurses, and PA’s wrong. They may have more education, but I studied for this course harder than you did. It’s specific. I will be better than you.

We did some exercises, some mock drills, everything that you do in order to pass this course. I made a shit ton of mistakes. Hell the first “patient” I intubated, I stuck the tube right into their stomach. It was comical looking back. A lot of those people in that class did want to see me fail. After all, I was just a measly, uneducated dental assistant in their eyes.

Finally, the MegaCode came. This is when you are given a case scenario and you must save the patient’s life. It went a little something like this:

Does the patient have a pulse? No? I looked into my team’s eyes, mastering the art of closed loop communication.
You– start high quality compressions. You– Place the AED now and count the compressions out loud for your partner so she can maintain her energy. Be ready to rotate with her on the 60th compression. You – Maintain the airway. Thrust the mandible forward and place an OPA. You – place an IV immediately. If you can’t get IV access, move on to establish IO access. Draw up 1 MG Epinephrine and wait for my orders. You – you record the patients vitals and create the timeline. I never used the word “you“, I looked them in their eyes and their eyes and body language confirmed they understood, or if I had to repeat myself.

Is the rhythm shockable? No? Administer 1 MG of epinephrine. Draw up another MG of Epinephrine and have it ready when I ask. Time keeper, you will be responsible for telling me when it’s been three minutes since the first MG of Epinephrine was pushed. The patient’s O2 sats are dropping. Our Tidal CO2 is not in range with quality compressions. We need to intubate. Grab the laryngoscope and depress the tongue until you expose the epiglotis. Slide the tube down the trachea and inflate the cuff. Confirm that you have properly intubated using a stethoscope. Are both lungs filling with air? Good. We will now start continuous compressions and you will ventilate very slowly every six seconds. Do not over-oxygenate the patient.

“It’s been three minutes!” Thank you. Push 1MG of Epi and draw up 300 MG amiodarone. Once again timekeeper, notify me when it has been three minutes. You – Rotate in early and start the next set of compressions, your partner is fatigued.

“It’s been three minutes!” Okay. Still no schockable rythym? Give a bolus push of Amiodarone, 300 MG.

I watched as my team worked hard together, synchronized as one to save this patient’s life. They looked to me for leadership. They believed in me.

“Time of death is 4:25 PM. Who’s going to tell the family?”

I will. After all I neglected the fact to remember our patient was in a car crash, and she was suffering from cardiac tamponade. I failed her and I failed my team. Luckily my patient was a mannequin, and there was no family to speak to. And worst of all, I had to go back to my boss who believed in me so much and tell him I failed.

So I went back to the office that day and told him. I said “I failed doc. I’m sorry that I wasted your time and money.” Again, he laughed. He looked at me and said, “So what? You quit? You’re giving up?” I replied “I don’t want to waste anymore of your time and money.” He looked me dead in my eyes and said sternly, “You are missing the point.”
I went home that night and did a lot of thinking. I decided I was going to study harder. So that’s what I did. I went back and passed the test. I didn’t just pass it, I killed it. (No pun intended.) The instructor told me that I would forever be wasting potential if I did not go to school and become somebody. She told me not only was she proud, but she was impressed by my desire to succeed. She told me ultimately, it would be the reason why I would succeed in life.

So what’s the point? Well, it took me a long time to understand why my doctor did what he did. It was never about the heart rhythms, it was never about the medications. It wasn’t about time or money. It was about not being afraid of failure. This is one of the most important lessons anyone has ever taught me. I felt humiliated, embarassed, and less in the beginning of that course. When I left in the very end after passing, I felt proud, happy, and confident that I truly could do anything in this world that I put my mind to. My boss didn’t have to do this for me. He didn’t have to express to me his words of wisdom. When I told him that I felt like I couldn’t do it, he could’ve avoided a world of headache and just said “Okay. Don’t go. I’ll keep my money.” But he didn’t.

Apparently, you believe in me- And I thank you for it.

I will take that lesson with me wherever I go in life.

Thank you Doctor, you are one of my biggest inspirations. I am proud to say I have enrolled into school and I will be pursuing my dreams without fear of failure. I hope I can save as many lives as you did. I also hope I can teach someone the lesson you taught me-

Believe in yourself

Choose Wisely


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