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The Peephole
by Heather Lyn Carone, MD on January 31, 2013
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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.