First year of anesthesiology residency, I'm on call and feeling salty because the senior resident clearly thinks more of my co-resident than me. She gets to do all the airways. We get an airway team page and run up to the wards where a guy with bad COPD and pneumothorax has been sitting there for a day. For whatever reason gen surg refused to put a chest tube in him, the details were unclear. I think they thought it would improve with some high O2 therapy and he was doing ok. Until suddenly he wasn't. I watched my colleagues intubate him and he went from desatting to full on cardiac arrest. Positive pressure ventilation and pneumothorax is a bad combo. There's a chance it was our fault. It stuck with me because I'll always wonder if it could have ended differently.
Fast forward Senior year, I get called early AM to the cardiothoracic ICU. Elderly gentleman just had heart valve surgery and he's starting to develop arrhythmias and he's desatting. Portable CXR shows he has huge bilateral pneumothoraces. I don't want to intubate him until he gets needle decompression and I don't want to mess up the timing. Hapless interns bring me 18 gauge catheters. The idiot ICU senior disappears once I've arrived because she passes the buck.
Luckily enough time has passed her colleague arrives to preround. She puts a 16-gauge IV catheter (interns couldn't find the 14) in each side of the chest to decompress right as I'm inducing and then I intubate. Hemodynamics are perfect, guy makes it to surgery and is eventually discharged from the hospital.
The elderly gentleman was the grandfather of one of my classmates. They had already just undergone a tragic loss in the family. I remember praying to God while I was intubating him that I wouldn't be the piece of shit responsible for another funeral. So I don't know if everything happens for a reason, but the crap code my first year taught me a valuable lesson.