the hospital known as the skilled nursing facility housed patients who were too sick to go home—or more commonly, back to the nursing home—but not acutely ill enough to qualify for a full hospital admission. Most of the patients were elderly, often in the advanced stages of dementia. Codes in the SNF were rarely successful. The team would go through the motions, cracking frail ribs with chest compressions, unable to locate accessible blood vessels beneath papery, gray skin. I arrived at such a scene in the room of an elderly man; his eyes were open, glazed, and vacant. Another senior resident was at the head of the bed squeezing air into his lungs with an oxygen bag and mask. A wide-eyed medical student pumped rhythmically on his chest,and arthritis, she was otherwise healthy, her surgical recovery fairly uneventful. Because she was in a unit where patients’ hearts are monitored continuously, a dangerous rhythm known as ventricular fibrillation was noted immediately, the electrical impulses too uncoordinated to function effectively. The best treatment is early defibrillation, or shocking the heart. The nurses had already pushed in the bright red crash cart and were placing rubbery pads on her translucent chest. Dr. Johnson is on the way. He was coming in early for rounds, breathed the head nurse. Okay, good, I replied, glancing at the sawtooth pattern on the monitor and welcoming the thought of the older doctor’s experience and calm. Charging . . . all clear . . . The woman’s chest heaved upward as the shock