With a family name like Heal I guess I was destined to become a doctor someday although interestingly enough, the Anglo-Saxon origin of the name means someone who lived in a nook or hollow. Sometimes working in the ER though, I do feel as if I’m living in a nook or hollow far from the normalcy of life in the outside world.
I initially chose to work in Emergency Medicine because I just couldn’t stand the idea of keeping a pager that invited people to call me at all hours of the night. As a young, idealistic medical student I thought it was great to have a pager. A sense of responsibility; that I could be there for a desperate worried parent in the middle of the night to reassure or guide them. That fairytale quickly faded though with the number of insane calls I received at all hours of the night from a couple who wanted to know at 1am if frozen burritos were classified as a “health-food” or not, or the dumb-ass parent who was concerned at 3am that their child hadn’t pooped in 2 days or the drunk 70 year old woman who called at 4am to remind me to speak to one of the other doctors who amazingly was not returning her messages (she thoughtfully called back at 5am as well just to make sure I wouldn’t forget). No, I wasn’t going to play that game I had decided. If I was going to be up dealing with idiots in the middle of the night then I sure as hell wanted to be sure I was getting paid for it.
The idea in fact came to me from an orthopedic surgeon I had trained with in medical school who told me that if he could do it all over that he would have gone into ER. “Protected time” he called it. You go in and do your shift and then you disappear – no pager, no answering service and no interruptions. Although I loved surgery, I couldn’t imagine living the way that poor man did. He was barely into his 30’s and had trouble squeaking out one day off per week. He had a girlfriend he never saw, hobbies that seemed like only a dream, and worked over 70 hours per week. After seeing that life, I was convinced.
I guess the part he forgot to tell me about was the quality of life in the ER. Its no surprise that so many ER docs “burn-out” way faster than so many other specialties. I think the human soul can deal with only so much misery before it crashes – before you’re looking to drugs as an escape from what you witness day in and day out. We deal with child abuse, violent alcoholics and crack-heads, rape, beat-up wives and girlfriends; social misery from homelessness to run-aways to people who can’t afford the medicine they need to survive. Oh, and I forgot about the heart attacks, strokes and violent accidents were you have to tell someone that you never met how sorry you are for their loss. It can take a toll on any human soul and it can make a person look at the world in a very different way.
I witnessed my share of trauma codes where young black men were brought in essentially dead from gun shot wounds (GSW’s) or stabbed close to death. The look in their frightened young eyes is not one you easily forget. Consoling their mother and trying your best to keep their siblings from “getting revenge” is unfortunately not something you learn in medical school. It made me see life in a very different darkness.
So I decided to scale back to work in community hospitals in suburban and rural America, and only rarely do I get back into the killing fields of Level One trauma inner city hospitals. Its here that I have more time to talk to my patients, to try to help them resolve their issues – to be more than just a doctor sewing up their cuts or making sure they’re not having “the big one”, but a friend who stands by them in their moments of need – no matter how many times they let me down.
These are the stories – the tragic, the uplifting, the funny and the “don’t try this at home” variety – of the people that I have willingly or unwillingly become friends with over the past decade.