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I am fierce. And if I be tamed, it is because I have found a soul strong enough to tame me and worthy enough to earn my yielding.
vaginaandmagirl (via valledeparaiso-xo)
War Stories
Occasionally I talk to normal people. Meaning people outside of the world of medicine. And they invariably say something like “I bet you’ve got some interesting stories” or “I’m sure you’ve seen some interesting things” (or “Is it really like House/Grey’s Anatomy/Scrubs/whatever”).
But I don’t like this question because I don’t know how to answer. I feel like they are asking to hear about some crazy medical experience. And I’ve got plenty…
–The former CIA agent who served during the Cold War and was admitted with urosepsis. He was delirious. He refused to talk with the entire medical team except for me (as a 3rd year student) because he thought they were commie spies. He pulled his NG tube and hid it in the tissue box, hoping to smuggle it out as evidence of illegal Soviet interrogation techniques.
–The old guy who went into vtach because he was playing with his junk.
–The patient dying in the ICU after infarcting all his organs with septic emboli from endocarditis due to IV drug use. His twin 9 year old boys watching him die. And the family member found using cocaine in the room.
–The guy who lives in his car with the 6000 catheters the VA accidentally ordered for him.
And many many more which make good tumblr-fodder…
But here’s the rub. When you ask a medical professional for a story don’t expect to hear the stories that really touch us. The ones that really matter: The old lady who’s broken and failed body continues to be tormented just a little longer at the insistence of family members that just don’t understand. The 41 year old woman desperate to be a mother who goes bankrupt with IVF, and presents with a second trimester miscarriage. The 8 year old kid who survives three codes in a day, but not the fourth. The first time you do harm. That time you get the phone call instead of making it.
These stories we hoard. We hold them close. They make us question. They make us feel things we often cover with sarcasm, cynicism, and dark humor. (Though sometimes we share them anonymously on the internet to help us cope.)
When you ask a medical professional for a story just to be entertained, well, ok I guess we’re usually happy to oblige. But of one thing you can be sure: the story you hear sure as hell won’t be one that matters.
*** i wrote this several months ago, and it’s been sitting in my drafts because i wasn’t sure about posting it. but today i’m feeling pensive, so i guess now’s the time.
Thank God for the internet and anonymity – because otherwise I would never be comfortable sharing the dark and disturbing and unresolved stories (my own and others’) that creep along the edges of every healthcare professional’s existence.
Hush...Don't Say a Word
The first time I cried, it was during clinicals. Ironic really, considering it was perceived a non threatening environment. Except I was completely threatened. The instructor was evaluating sterile wound care at the patient bedside, and after about three sterile fields that were ripped from the bedside table with a curt, “do it again,” I felt tears flooding my eyes. The patient, alert, looked at me with pity, fellow students surrounded the bed, silently writing notes - likely what they will do differently to avoid this catastrophic fail. Tears fell, as I finally met expectation, but there was no victory. “You shouldn’t cry in front of patients,” commented the Instructor. I vowed I would never show emotion again.
The second time I cried, it was during orientation in Med Surg, the fear of making a mistake, the pressure to take more patients, the demands of the preceptor, patients, and forgetfulness began to build up. The struggle to keep up with charts, meds, assessments, and the overwhelming impossibility of it all. Tears threatened at the nurse’s station, and before I knew it, I was whisked away by a nurse educator into a patient’s bathroom.. “Never let them see you cry.” She said, and left the room. I looked around, through the tears. At least she had the good sense to ensure it was a confused patient’s room. I wiped the tears that betrayed me again, and carried on.
The next time I cried, it was my first code. The patient was a DNR, but the family wasn’t sure. When he stopped breathing, they panicked. And so did I. But still, we coded him, and he survived. I held it together, as we tended to him, post cardiac arrest. I held it together while I thought about his broken ribs, hypoxia, and quality of life. I held it together while the family held hands in a prayer circle and reinstated the DNR. I lost it when I watched the heart rate on the monitor slowly go down, and I slipped out of the room silently to cry in the supply room.
I trembled, the first trauma patient I received in Pacu, a 90 y/o female, broken pelvis, s/p ped struck, after being dragged by a bus for five blocks. I trembled, as I fought to keep up with her rapidly depleting blood volume. I trembled each time she coded on that shift. I fought back the tears when she gave up the fight. “Don’t let anyone see you weak.” Said the charge nurse. And I cried the tears silently.
I felt a void the day I took care of a 17 y/o female who overdosed on energy drinks. I felt a void as we ran a marathon attempting to save her young life. I didn’t feel anything while we maxed out on pressors, pumped her with fluids, and she continued to decline. I felt detached while we invaded her body with a catheter to drain the toxins from her blood in emergent dialysis. I felt removed from the scene when she died, her family destroyed, and my fellow nurses wept at the climax of a heart wrenching day that resulted in defeat. I was her nurse, and I had failed her, but my eyes remained dry. Every so often there’s a patient that affects the unit, one that unifies the team, I looked around as though I was viewing it all from the gallery of an OR, and understood there was no shame in crying, and there was no shame in feeling empty - I remained silent, realizing a nurse didn’t have to justify being one or the other. Sometimes you needed to grieve to move on, and others you need to detach to survive it all.
It was late night in Pacu, when we received word we would need to accept a patient from the OR status post complication of a VATS. (Video-Assisted Thoracoscopic Surgery). A simple procedure had been complicated by an error that a 1st year surgical resident made - a catastrophic nick of an artery they couldn’t seem to repair immediately. The family was insistent that she suffer no more procedures or extraordinary measures. The patient was to come to a secluded room in Pacu, so the family could say their goodbyes. There is perhaps a million ways that a nurse and doctor may disagree, but it only takes a moment of commonality to bridge the gap, or remind us of our humanity. I stood with the surgical resident as the family surrounded the patient, crying and comforting one another and telling their loved one it was ok to let go. We stood together in the shadows of the corner, and the resident began to cry. I squeezed her hand gently, and felt my own tears fall in shared understanding. She wasn’t alone.
This is so well written, sad and beautiful at the same time. I find it toxic to ORDER not showing emotions, especially when death is involved. Such a wonderful thing you did for the resident. Thank you. <3
^^This is the kind of writing that will change the way we do medicine.
I cry with patients who cry, I laugh with those who laugh… sometimes both within the space of minutes. Providing health-care means actually caring, and if your language of caring for/about someone involves tears, then by all means, cry if it will help you provide better health-care for them.
In my >15 years of being in medicine, I have never once seen a patient or family reprimand a professional (doc, nurse, other) for displaying sympathetic sadness.
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what in the HECK tumblr what is this streamlined NONSENSE with the dang comments maybe we don’t want everything spick-and-span CLEAN for crying out loud give us some CHAOS give us a whole block of misaligned nonsensical reply conversations just SHOVED into every which way in the bottom of a post just BURY US IN UGLY GREY LINES we yearn for bedlam, for pandemonium, for PURE BLOGGING MAYHEM got dang it the only thing we want streamlined is our menus you put the appetizers in the FRONT and the desserts in the BACK and the reblog comments ALL OVER THE FLIPPIN’ PLACE SHEESH
or whatever it’s fine
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when you’re singing in the choir at church at 3:30 and you have to make it to the gay pride parade at 3:45
me coming out of the closet
She’s so attractive I’m afraid if I stare too long my eyes will begin to burn.