It’s been a few years since I’ve written on this thing.
I’ve been working trauma nights for the last few weeks, which mostly has reduced life to work, preparing for weekly lectures, and sleeping. Lather, rinse, repeat. The one night off a week is spent trying to stay awake at night, watching the city fall asleep at my “lunchtime”, inevitably screwing up my sleep schedule and showing up to work exhausted the next day. Feels a bit robotic.
Started off the day tired today. I stayed up late doing admin and research-related work yesterday, and showed up to work a few minutes late — unshowered, exhausted, and hungry. Some guy I know had the brilliant idea of eating oatmeal for dinner last night. Genius.
We were one resident short, and the junior flying solo today was in the OR when I showed up for signout. That’s ok. Checked up on the ICU patients. One guy – in multisystem organ failure for days – was maybe starting a slow spiral down. I was worried about him yesterday – wait, this morning – he had reminded me too much of other patients I’ve had in the past who teetered in critical illness, then gracefully drifted down to death in one fell swoop. His nurse paged me, he just wasn’t looking entirely right. I agreed. Studied the available data, assessed him an – beep, beep. The junior is feeling sick and had to scrub out of the case, vomiting.
Down to the OR I go. It goes ok, and is quick. Looking at the clock, I want to get back upstairs.
“Hey… was that your patient who coded?”, inquires our anesthesiologist.
“… what code.”
“A few minutes ago… bed 12…”
Of course.
Case wraps up, I run upstairs, he is dead. Family is all in the room and crying. Nurse also about to start crying. It just happened so fast, the swift descent of the critically ill patient. Just yesterday, I laughed and chatted with his family and explained the complexities of his clinical situation. Knowing he was ill, we had remained optimistic.
I am torn up and doing the usual rapid fire internal debriefing of the last week to see if we had missed anything, standing with patient’s wife and siblings. The patient’s son, probably in his early twenties, walks out of the room. Tears streaming down his face, chest heaving with sobs of grief.
Painful déjà vu again. Reminded me of that first week of intern year, getting hit hard and having to compartmentalize and shut down the emotions to keep up with the wo – beep, beep. Trauma in the ER, now. Sigh. Well, the PA will help with tha – beep, beep. Transfer patient in the ER now, heading to OR.
Sigh. Shut it down. Off to the ER. See the new girl. Tee her up, get her to the OR. Operate. Finish. She does great.
Off to the ICU again, stop by room 12. Empty, body gone, family gone. Still hasn’t been turned over. In the stillness of the dark morning, I stand at the doorway and just watch the emptiness. The room is a shell, missing the vitality and hope of the patient & his family who were faithfully by his side for the last two weeks.
In third person, I can almost see myself from six years ago, standing outside of Mr. G’s room, sorting through the roller coaster of that day before breaking down in the elevator, for exactly five floors.
A lot has changed in six years. A lot of growth, grief, cheer, and maturation. However, some experiences remain just as raw as the first time.
Finally get a chance to grab a bite and shower, only to find out the shower in my call room has a backed up drain and spews rusty, brown water. Some guy I know is eschewing oatmeal tonight, and going for the bacon.
scrappydogs goes west 