In Your Own Words
When people learn I work in the emergency department they usually ask, “How do you do it?” Or they say, “Wow, I bet you see a lot of crazy things.” My answer aloud: “It’s never dull.” My answer in my head: “You have no idea.”
In what other profession do you walk out of a room where someone has just yelled, “I’m gonna kill you, Bitch!” and laugh? Where else do you preform CPR, call a time of death, then talk about your weekend plans all in the same breath? It gets even worse.
Even the worst ones – a rape or a case of child abuse – have to be walked away from and on to the next stomach ache, cough/cold or heart attack. It may, for a minute, leave a pit in your stomach the weight of bowling ball. But even then, you can usually get rid of it with a sigh so deep that it goes all the way down to your toes. Sometimes it takes two sighs.
Sometimes I give a high five to someone on my team. Not to say “congrats,” but to feel a little human touch and know I’m not alone.
If a tear feels like it might try to work its way up from your throat, you swallow it quick. It does no one any good to let it out. The family can’t see it. Your co-workers can’t see it. We all get one turn to break down and then everyone else has to be strong. But we can’t all walk around like sobbing messes. When I see another on my team tear up (children who have died is often the cause) I know this time it can’t be my turn.
So we suck it up. We learn to turn “it” off. Too well, in fact. What choice do we have? We cope. We walk into fatal car accidents with our first thoughts (mentally, at least) being, ”were they drinking, were they high, they probably weren’t wearing their seat belts.” Something, ANYTHING, to separate us from this. Something, ANYTHING, so we can sleep at night and try to convince ourselves that we are not so temporary. That our spouses and our children are not so temporary.
When we can’t find reasons, we have no choice but to swallow that lump. We come home, we hug our kids, and we cope. By the time we wake up for our next shift, the lump is almost gone.
Each time I’ve had to do that, I’ve lost a little something. I shut off a pathway to sadness, remorse or fear so many times that now those feelings are hard to come by at all.
But I’m not alone. And it’s the people by my side who make me feel normal about this chaos that we live in. This peephole into reality that only a few of us see. We, more than anyone, understand the temporary nature of it all. The unfairness of it all. That even children aren’t safe from this awful game of life that, no matter what, ALWAYS ends in death. What choice do we have? This is our job. This is our life. Even if we quit, it’s too late. Once you peep through that hole you can never pretend you haven’t seen it.
If you don’t live in our world then that last sentence is morbid – creepy even. But in our world, it is fact. It is life. It is truth. We have no veil of ignorance when it comes to our own mortality. Much to the dismay of our family and friends we sometimes come off as “cold” and (I hate this one)…”insensitive.”
So we may cry a little less. But here is the upside: we also gain a new ability to laugh. To love fully. To live without regret. We generally don’t waste time on negativity or pessimism. We understand fully “one life” and we aren’t about to waste it. We wear our seat belts and don’t drink and drive. We live smart, but never in moderation! We don’t shelter our kids, because even children without trampolines are sometimes “temporary.” So we let them jump and we let them laugh, we just have a net! We don’t keep them home from the park because we are worried about the “Bogeyman,” because we know most of the time it’s “Creepy Uncle Ralph” who is causing the trouble.
If I did this job alone, the isolation would drive me insane. But I don’t. My co-workers are my sanity. My family: my rock. Together we get through this life with our eyes wide open.
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To turtlemama: I have said to my husband (who is not in health care) a dozen times that there is nothing more agonizing and painful and bone chilling than the howl of a mother that has just been told her child is dead. I mourn for the child, of course. But, The death of the child is only half the pain we feel. The look on the parents face when we have to tell them their child in gone is the second half.. Simply heart wrenching. It's hard not to run out of the room! It's hard to keep looking them in the eye...It's hard not to vomit. Of course it's not as hard as losing my own child but it really really freaking sucks. (Cant think of better words). Most ED docs will go through this scenario hundreds of times before we retire. It's probably the death of children that makes us immune to everything else. After you have seen the death of a perfectly amazing innocent soft sweet child...what could be worse? It's not that our pain is greater. It's not even close. iIt is just that we have to do it over and over and over. So to you, turtle momma, I'm truly sorry for the loss of your baby. I have 4 of my own and imagine that every day must be a challenge for you. I'm sorry if my writing implied anything less.
To disabled nurse: I also often say...I'd pick a average intelligent resident who has compassion over a brilliant one who has none. After 3 years of training we can make (almost) anyone a well trained, competent Emergency Physician. It is much harder, sometimes impossible, to teach compassion. it is amazing how many young docs have never had pain. When I hear..."whenever I get (insert painful condition here) I just take a Tylenol" I want to rip my ears off. As if somehow they would know what is like to have someone else's pain.. The same docs (and nurses too) roll their eyes at patients with an addiction or those that couldn't afford their medications but bought cigarettes... It's a general inability to put themselves in someone else's shoes. Empathy. I try to teach it everyday. It is especially easy when I have a resident to my right feeling sorry for the 4 year old in room 10 covered in cigarette burns while the resident to my left complains about the belligerent drunk 18 year old in room 11 in police custody. Connect these two dots my friends! Why do we lose compassion when that child turns 18. We all come from different places..walk a mile in someone else's shoes... Empathy empathy empathy! So...I try to always set a good example and keep preaching. Most of the trainees just need to be taught these lessons just as they are the taught the lessons of STEMI management. And luckily, most of them eventually get it, even if they didn't come with it. My inability to "turn things off" only has to kick in when the show must go on. Like Dr Crespo said...it is an honor to be called to take care of the sick. It is one I truly cherish.
written by turtlemama , February 15, 2013
Also, I just want to clarify that I had no problems at all with my husband's treatment in the ER-- I was incredibly impressed with how well the resident handled herself given the situation she was facing with my husband screaming in pain.
written by Doug , February 21, 2013
written by Gregory Hayes , March 22, 2013
I have heard others (who have never worked in an ER) say "I understand what how it is there." That is just plain crap. For those who have never worked in EMS, the ER and ICU cannot understand what happens there. One minute we are trying to save a life, the next were are spat on or told we don't know what we are doing (and you wonder where some people get their medical knowledge.)
Yes it does take a special person to work in an ER, I have seen RN's from general med floors run away and say that we (those that work there) are crazy, and that may just be true. I have seen doctors (residents) who couldn't handle it. For them it was a case of not 'having control' as many times the staff (RN's, techs) are doing things before they can react. Yet, I am ever so grateful for the medical providers I work with, who see me as a vital part of the team, who listen to what I say and respect me and value my input on the care of people who come to us.
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