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What a crazy last pre-vacation shift.
Yesterday… a neighboring ER had a big fire.
Crazy, I know. Feels like we’re in a movie.
All their patients are diverted to us and some surrounding emergency rooms. The chaos? It’s pure emergency medicine. This is why I love the field. Unpredictable to the max.
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Ugh. A patient came to us in the worst way possible today.
Family called EMS because she had a seizure while sitting on the toilet. She stopped seizing after a minute or so but was uncommunicative in the field. She came to us; she was intubated, stabilized and worked up. 55 year old female, no known medical history.
Her CT showed a massive hemorrhage. A ruptured aneurysm. Straining on the toilet — a classic textbook case. Neurosurgery said there was nothing to do. Her neuro exam was not promising: her gag reflex: gone; her corneal reflex: minimally responsive. No spontaneous breathing, no response to pain. Pupils fixed, unresponsive to light. The machine kept her breathing but her brain had died.
So sudden. So unexpected. So young. Shit.
by Joe Lex Emergency Medicine is the most interesting 15 minutes of every other specialty. – Dan Sandberg, BEEM Conference, 2014 Why are we different? How do we differentiate ourselves from other specialties of medicine? We work in a different environment in different hours and with different patients more than any other specialty. Our motto … Continue reading Thinking Like an Emergency Physician
A phenomenal read.
It’s crazy how...
...after a long 12.5 hour day, with frustrated patients and stress and lots of paperwork...
I leave the ED smiling.
(Such a high. I’m in such a good mood. The gorgeous spring weather certainly doesn’t hurt.)
Open letter to the one receiving the news:
I wish I didn’t have to tell you this. I wish we could meet under different circumstances. Ones where my smile is large and your sighs are of relief. When I can crack a joke about being weird or whatever else seems (marginally) appropriate. I truly, wholeheartedly, wish I didn’t have to sit here. And have a somber face; control my voice, speak slowly, but steadily and clearly. Hold eye contact and will my own tears not to show. But oh well, such is life. And here we are. I sit in this small chair so I can be close to you. You clutch and crumple a tissue in your hand like that might change the news I have for you. But one look in my eyes, and yours are watering: you know the truth. I don’t have to utter a single word, you already know. But you still hold on to hope and quietly mutter “please…. Don’t tell me”. I give you a few more moments of blissful ignorance. Because I know: the moment I open my mouth, my words will shatter your world to pieces. I will be able to hear your heart break, like I have heard many before. It doesn’t make it any easier. I collect heartbreaks like stones that weight on my own heart. It never hurts less to hear that shaky breath before your words squeeze my heart into stopping. But it doesn’t even remotely compare to the pain I know you feel. Trust me, I’ve been there. I’ve been on the other side of this conversation. Which is probably why this hurts me too. But this isn’t about me right now. It’s about how you keep moving after your heart stands still. How you get up when the world is falling down. I wish I had an answer…
It’s better when you have another loved one with you. So you can squeeze their hand until you cut off circulation. So you can hold each other together as you threaten to fall apart. But sometimes, all you have is me. And my lifelong commitment is to be there. To hold your hand, offer you a hug, and ask about your loved one. This is the most painful part. But listening to your stories about how they called you daily, or how they visited by surprise because they missed you too much, makes it harder and easier at the same time. I just want to thank you for the honor of today. For trusting me to take care of your loved one, and for the absolute privilege to be the one to tell you that they have passed and have gone on to a better place. I promise, I prayed for them before calling time of death, and carefully made a sign of the cross on their forehead, quietly wishing for God to welcome their soul into Heaven and comfort the ones who stayed. Yes, I also asked God to comfort you. I hope you can hear Him as I talk. I hope you can feel Him as I sit and listen. Because I am nothing but a vessel for His love. And I am truly sorry for your loss.
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