There was a very nice medical student in our ED recently. It was her first rotation in the emergency department and she looked at the tracking board, the ambulances, the activity and said that it seemed like ‘controlled chaos,’ and made her (quite reasonably) a little uncomfortable at first. A few days later she had settled in nicely and was learning and engaging quite well.
Oh the memories reading this brought back. I started in Peds ICU, and during those 12 years had many many instances of codes/expected passings (we took care of Peds oncology patients at the time), unexpected passing (one little heart kid who was to be transferred to the floor 2 days post op passed really unexpectedly--sudden cardiac death sucks)...yeah, could probably write volumes myself on this. But it’s like ripping an old scar open that I thought had healed.
I’ve experienced much the same as you described. As a respiratory therapist for 46 years I don’t even want to know how many resuscitations I’ve been a part of, from NICU to ICU to ED and everywhere in between, with terminal extubations perhaps the hardest. I don’t know why God chose us to do this job, but I know we both do it with compassion and empathy, day after day, year after year. It is indescribable, and only our colleagues truly understand, but that’s okay. Some things are better left unsaid.
I will always remember your name as one of the greatest physicians I’ve ever worked along side. Your gifts and talents goes far beyond your skills as an ED physician.
I agree with Shauna. The memories are flowing right now. What's equally amazing is the similarities of these memories and stories. Last evening I cared for a 32 yo gentlemen with an amputated lower leg who has lived on the streets for 7 years, sleeping in his wheelchair while carrying an impressive knife for protection. He came in cold, hungry and tearful. He doesn't want to return to the streets. Sadly, no family, no friends, nothing. We couldn't find a shelter for him (he didn't want to go to one anyways). He was too frail for a rehab center. Fortunately, our hospitalist admitted him. The whole experience broke my heart. We work in a strange environment. I thought about writing a job description - too broad for words. Ed - fantastic piece. Thanks. You are my inspiration. Thanks for verbalizing what we feel. We went into medicine to help the poor, frail, injured and ill. The barriers are overwhelming. Sad. Lonely. Pathetic. Troubled. Caring. Wanting. Hoping.
I really appreciate your work, Edwin. Both your ER work and your writing. I'm a retired Hospice chaplain. I used to sit in deep intimacy with dying people and their families....only to run into a wife or a son at the supermarket two weeks later and be unable to remember who they were. I knew that I knew them in a profound way, but I didn't know them at all in "real life."
I've seen death in my family, my grandmother Ada who died peacefully from CHF and my first wife who died at home from lung cancer. I've also seen corpses at car crashes and murder scenes. But I realize that's rare today. I'm grateful because I don't fear death itself. I only pray it will come for me as it did for Grandma Ada.
If life were "normal", death would be a part of life. We all have grandparents and within our lifetime, they all die. Once in a while, a young person dies. The actuarials say that 18 % of the population in my birth-year are already gone into the hereafter. But, we've sanitized death to the point that we may never see it at all. We can't see the value in a cemetery plot so our loved ones are cremated, even composted. We get back an urn or a little wooden box. Something to scatter into the wind, or under a favorite rosebush. We have a memorial service with pictures, slide shows, stuff to eat and spontaneous eulogies, then head on home for an evening of Netflix. I've seen a lot of death over the years, but rarely have I been able to anchor that event in the context of the life that ended. We strived mightily to postpone it, prevent it, avoid it. Only after all available means were expended, did we acquiesce and write "DNR" orders as a bouquet on the 3-inch thick record. There were clinical features, pre-existing conditions, the 'drama" of how a fulminant illness unfolds, but never the context in which the individual, family and community were effected by the event. Death has been isolated, encapsulated, dehumanized. Once, we lived in a more constant, closer juxtaposition to the border between life and death. Now it's more of a made-for-TV kind of event. There's something vaguely disturbing about what we've done with it, to it. We recoil in horror about the concept of choosing a day and time for it, even when it is inevitable. But, why shouldn't we have that right and not have to face shaming for even thinking of it? We now broadly believe that birth is a consensual event by parent(s). Why shouldn't death be similar?
I really admire you for writing about your experiences as an ER Doc with utter honesty. I've met so many who aren't as open with their thoughts, opinions, and observations about their work within the hospital. Anyway, I'm a writer as well and would love to connect somehow. I feel as if we could collaborate in some way. Perhaps I could pitch you on an idea I have. Email me at kellyjett213@gmail.com if you're interested!
“We then go home and find ourselves powerless to describe it all.” Or, as in my case, any attempt at description or sharing is/was avoided as the experiences are too morbid, ugly and/or tragic to impose on others.
To paraphrase what you stated - the majority of “normal” people have little direct exposure to death and the myriad tragic events we see or have seen. I always felt that any attempt to share what I experienced would despoil others’ innocence and sadden them. I felt it was my burden…probably not the healthiest approach but seemed right at the time(retired now though memories remain)
Once more you have identified another unique reality of life in Emergistan (and my life) and communicated with clarity and heart. Thank you.
Oh the memories reading this brought back. I started in Peds ICU, and during those 12 years had many many instances of codes/expected passings (we took care of Peds oncology patients at the time), unexpected passing (one little heart kid who was to be transferred to the floor 2 days post op passed really unexpectedly--sudden cardiac death sucks)...yeah, could probably write volumes myself on this. But it’s like ripping an old scar open that I thought had healed.
THIS. I can see their face, the room they were in, the time of day -- the family, the staff..... not their identity
I’ve experienced much the same as you described. As a respiratory therapist for 46 years I don’t even want to know how many resuscitations I’ve been a part of, from NICU to ICU to ED and everywhere in between, with terminal extubations perhaps the hardest. I don’t know why God chose us to do this job, but I know we both do it with compassion and empathy, day after day, year after year. It is indescribable, and only our colleagues truly understand, but that’s okay. Some things are better left unsaid.
I will always remember your name as one of the greatest physicians I’ve ever worked along side. Your gifts and talents goes far beyond your skills as an ED physician.
I agree with Shauna. The memories are flowing right now. What's equally amazing is the similarities of these memories and stories. Last evening I cared for a 32 yo gentlemen with an amputated lower leg who has lived on the streets for 7 years, sleeping in his wheelchair while carrying an impressive knife for protection. He came in cold, hungry and tearful. He doesn't want to return to the streets. Sadly, no family, no friends, nothing. We couldn't find a shelter for him (he didn't want to go to one anyways). He was too frail for a rehab center. Fortunately, our hospitalist admitted him. The whole experience broke my heart. We work in a strange environment. I thought about writing a job description - too broad for words. Ed - fantastic piece. Thanks. You are my inspiration. Thanks for verbalizing what we feel. We went into medicine to help the poor, frail, injured and ill. The barriers are overwhelming. Sad. Lonely. Pathetic. Troubled. Caring. Wanting. Hoping.
I really appreciate your work, Edwin. Both your ER work and your writing. I'm a retired Hospice chaplain. I used to sit in deep intimacy with dying people and their families....only to run into a wife or a son at the supermarket two weeks later and be unable to remember who they were. I knew that I knew them in a profound way, but I didn't know them at all in "real life."
I've seen death in my family, my grandmother Ada who died peacefully from CHF and my first wife who died at home from lung cancer. I've also seen corpses at car crashes and murder scenes. But I realize that's rare today. I'm grateful because I don't fear death itself. I only pray it will come for me as it did for Grandma Ada.
Exactly. Once again, you capture my thoughts and feelings.
If life were "normal", death would be a part of life. We all have grandparents and within our lifetime, they all die. Once in a while, a young person dies. The actuarials say that 18 % of the population in my birth-year are already gone into the hereafter. But, we've sanitized death to the point that we may never see it at all. We can't see the value in a cemetery plot so our loved ones are cremated, even composted. We get back an urn or a little wooden box. Something to scatter into the wind, or under a favorite rosebush. We have a memorial service with pictures, slide shows, stuff to eat and spontaneous eulogies, then head on home for an evening of Netflix. I've seen a lot of death over the years, but rarely have I been able to anchor that event in the context of the life that ended. We strived mightily to postpone it, prevent it, avoid it. Only after all available means were expended, did we acquiesce and write "DNR" orders as a bouquet on the 3-inch thick record. There were clinical features, pre-existing conditions, the 'drama" of how a fulminant illness unfolds, but never the context in which the individual, family and community were effected by the event. Death has been isolated, encapsulated, dehumanized. Once, we lived in a more constant, closer juxtaposition to the border between life and death. Now it's more of a made-for-TV kind of event. There's something vaguely disturbing about what we've done with it, to it. We recoil in horror about the concept of choosing a day and time for it, even when it is inevitable. But, why shouldn't we have that right and not have to face shaming for even thinking of it? We now broadly believe that birth is a consensual event by parent(s). Why shouldn't death be similar?
Well done as usual Ed!
I really admire you for writing about your experiences as an ER Doc with utter honesty. I've met so many who aren't as open with their thoughts, opinions, and observations about their work within the hospital. Anyway, I'm a writer as well and would love to connect somehow. I feel as if we could collaborate in some way. Perhaps I could pitch you on an idea I have. Email me at kellyjett213@gmail.com if you're interested!
“We then go home and find ourselves powerless to describe it all.” Or, as in my case, any attempt at description or sharing is/was avoided as the experiences are too morbid, ugly and/or tragic to impose on others.
To paraphrase what you stated - the majority of “normal” people have little direct exposure to death and the myriad tragic events we see or have seen. I always felt that any attempt to share what I experienced would despoil others’ innocence and sadden them. I felt it was my burden…probably not the healthiest approach but seemed right at the time(retired now though memories remain)
Once more you have identified another unique reality of life in Emergistan (and my life) and communicated with clarity and heart. Thank you.
https://youtube.com/watch?v=GU0d8kpybVg&feature=shares
Reminds me of the ER