You Have a Story to Tell; or Not.
Physicians, nurses and others working in these hard times. You don't have to tell your story if it's just too hard.
This was my column in EM News last March.
Life in Emergistan
A Story to Tell—or Not
Leap, Edwin MD
Emergency Medicine News: March 2021 - Volume 43 - Issue 3 - p 22
I do not work in academia, but now and then I have the wonderful opportunity to talk with residents or students. I discuss things that can help graduating residents have happier, healthier lives and practices. But one idea stands out in light of all of the suffering and struggle of the past year: You don't owe anybody your story.
What I mean is this: We have all been cornered by someone at a dinner party who said, “Wow, the ER! What's the worst thing you've ever seen?”
I finished residency in 1993. That makes me older than I'd like to admit. It also means I have some tales of woe after practicing for 28 years. I have some dark stories, some sad stories, and some heart-wrenching, tear-jerking stories of tragedy.
I have some that are mine and some that I saw or heard secondhand. My brain has a special file that accumulates stories, real and fictional, for later use or to make my future dementia more entertaining to others.
I also have a few stories, a very few, that I really can't discuss. I have spoken of one of them only with my wife, and I don't do that often. It is too hurtful. I have a chill down my spine just writing about it.
Profound Effects
This is a hard job, practiced on human beings in the most terrible circumstances. We learn in this job not only about the frailty of the human body, but also find ourselves in a complicated web of connections. We intimately learn how the loss of one life, or even the suffering of one, ripples through that web to touch so many with loss. It is jarring to realize that we will be remembered by those in the midst of their times of terror. Our work makes us players in their sagas. This has profound effects on us as well.
Many of you, some young and others old, have been immersed in the great misery of COVID-19. Because of this, you have done your best to save the lives of those affected by the virus. In all too many cases, despite your best efforts, that monstrous little carrier of RNA won the fight. Sometimes education and skill just can't outperform the elegant simplicity of a tiny, deadly pathogen that in one form or another has been surviving and thriving for untold eons.
Because you are high-performing, incredibly skilled, dedicated, and educated life-saving machines, it is easy for those deaths to feel (quite falsely) like failures. It is also easy for those deaths and the suffering and disability associated with even those you saved to inflict deep gashes on your own psyches. I have no doubt that those of you who have fought the good fight against COVID-19 have stories that bring tears to your eyes and others you just can't discuss.
Medical Voyeurs
Many will want to hear your stories in the coming months and years. Some will offer you encouragement and comfort. Others, also suffering from bad memories, will tell you about frightening dreams and anxiety, and they may want you to share yours so they can process their own. It is fine if you want to tell your tales; you may find it therapeutic. It may also be useful for advocacy as we prepare for future pandemics.
Others will ask for different reasons. They are medical voyeurs who simply want to know how bad it was. They may be family or friends, strangers, or sometimes even reporters. Their goal is not to help you but to hear something titillating.
You do not owe them a story. You are under no obligation to tell them anything. I have advised that physicians make up or modify stories when asked about the worst thing they ever saw. (Many of them ultimately want blood, pus, or foreign bodies in body cavities.) You can walk away if you wish. You can tell them a strange tale of a raccoon, a car battery, or a severed hand. You can tell a funny story instead.
Or you can simply say, “Trust me. You really don't want to know how it was,” and then move on to another party guest.
When the time comes, you can tell your story at your leisure. Or never at all. Because, in the end, it's yours and yours alone.
Here’s the link to the original column at EM News.
This has by far been the most suffering I have ever seen in my career. It has been heartbreaking to say the least knowing what you are doing for the ones with the virus will not survive despite our teams efforts. What has helped me is knowing we have made a difference for some like your family member and of course our God. I have 17 shifts left before I retire and hope the next generation will not have to see what we have and be nurses and team members that will make a difference like we are supposed to do in our field!