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I need a vacation... - Nobody wears a white coat any more...
...a tribute to becoming a doctor.
ayradyss
ayradyss
I need a vacation...
Today, O Best Beloved, ended with a code. A coda, if you will indulge me the black-humour wordplay, to last night's grief.
I don't know his name, his age, or his address - they had the information in the computer but I didn't hear them or spend the time to take a sticker from the chart. A gentleman in his 60's, by the medic's guess, found unconscious and in cardiac arrest. He'd been down for a little time at least, but less than an hour. He came in in v-fib (when your heart is just sort of randomly squeezing without purpose) and they shocked him, and started lines, and did CPR, and for a few brief moments he had a heartbeat, but then it went away again. V-fib/V-tach/Asystole. Again and again and again. And finally Dr. K looked up at the screen of the heart monitor, and the heart doctor looked down at the person doing the airway bagging, and Dr. K said "Stop CPR" and the heart doctor said "Stop bagging." And everyone looked down at the man on the cart, one arm hanging loose off of the edge where it had fallen during one of the jolts, and Dr. K said "Call it?" and the heart doctor said "Call it." And I looked over at the chaplain and I nodded, and she mouthed "Code?" and I nodded again.
They drew the curtains and they disconnected the machines and I left to tell Iwona that it was the end of my shift. She shooed me out of there. I went back to the trauma rooms, and I stepped inside the drawn curtains and looked down at the body. Not ten minutes had passed, but his face was grey and sunken, his eyes half-slits, still moist for now. Was-a-man, is-a-body, such a subtle change. They'd gotten hold of his relatives and the chaplain went to see them. I didn't. I stared down at him for a few more minutes, what was left of him, so different from the little boy of last night's drama and yet the same...
Someone said: Is this your first code? I said no, last night was. Someone else said: That wasn't the same, it was something strange. And it was, last night, strange and surreal. I found out some more things: There was a carseat. I don't know how he got dislodged from it. That takes away some of the fury. They did an EEG and found, as we predicted, no brainwave activity. They have him on basic supportive measures - a ventilator, fluids to keep his empty body going until his father arrives from Arkansas. His mother's already decided that whatever organs aren't too hypoxic to donate will be harvested and donated. That takes away some of the pain. They're still there, the fury and the agony and the indelible memory of his face, his half-slitted eyes (why do they open like that?), his heaving chest as the machinery of life struggled to keep functioning without purpose or guidance. But they're eased a bit, and with time, that bright broken innocent part of me will heal and cease to bleed. But I hope and I pray, O Best Beloved, that there will never come a time when I can look upon death without that breaking and wounding. I believe as firmly as you do, you who listen to my tales in the dark and lonely hours of the night, that I will never lose hope, never lose compassion, never cease to be stirred by all that is pain and injury in this world of ours. It is that which fuels me, which gives me the burning, driving need to heal where I can heal, comfort where I can comfort, and to leave some tiny footprint in the lives I touch, some tiny change for the better.

Things happened today, O Best Beloved, things that I wanted to tell you about. I wanted to tell you about the boy and his bicycle, when I stopped by the road and waited for the paramedics to come, and then saw them again in the ER later on. I wanted to tell you about the woman who accidentally took a pill that bought her a ticket to an overnight stay. I wanted to tell you about C, the PA student, and how we got to look over things together for a while and I felt that connection of camaraderie. But I think most of all I wanted to tell you about the man who died, and the boy from last night, and I wanted to tell you that the second time I've seen death it still hurt, still twisted, still bled inside me...but that sometimes it's easier to face and easier to understand than others. I walked out of the ER today without a smile on my face, but by the time I got to the car, I had placed the memory of his face in a part of my mind that sprung into being last night, a place to keep the things I must learn - if not to love - to accept the inevitability of. We live. We are hurt. We die, all of us, in the end.
I wish and I don't wish that knowing that made it hurt less.

To every [thing there is] a season, and a time to every purpose under the heaven:
A time to be born, and a time to die; a time to plant, and a time to pluck up [that which is] planted;
A time to kill, and a time to heal; a time to break down, and a time to build up;
A time to weep, and a time to laugh; a time to mourn, and a time to dance;
A time to cast away stones, and a time to gather stones together; a time to embrace, and a time to refrain from embracing;
A time to get, and a time to lose; a time to keep, and a time to cast away;
A time to rend, and a time to sew; a time to keep silence, and a time to speak;
A time to love, and a time to hate; a time of war, and a time of peace.

What profit hath he that worketh in that wherein he laboureth? I have seen the travail, which God hath given to the sons of men to be exercised in it. He hath made every [thing] beautiful in his time: also he hath set the world in their heart, so that no man can find out the work that God maketh from the beginning to the end. I know that [there is] no good in them, but for [a man] to rejoice, and to do good in his life. And also that every man should eat and drink, and enjoy the good of all his labour, it [is] the gift of God. I know that, whatsoever God doeth, it shall be for ever: nothing can be put to it, nor any thing taken from it: and God doeth [it], that [men] should fear before him. That which hath been is now; and that which is to be hath already been; and God requireth that which is past.
And moreover I saw under the sun the place of judgment, [that] wickedness [was] there; and the place of righteousness, [that] iniquity [was] there. I said in mine heart, God shall judge the righteous and the wicked: for [there is] a time there for every purpose and for every work. I said in mine heart concerning the estate of the sons of men, that God might manifest them, and that they might see that they themselves are beasts. For that which befalleth the sons of men befalleth beasts; even one thing befalleth them: as the one dieth, so dieth the other; yea, they have all one breath; so that a man hath no preeminence above a beast: for all [is] vanity. All go unto one place; all are of the dust, and all turn to dust again. Who knoweth the spirit of man that goeth upward, and the spirit of the beast that goeth downward to the earth? Wherefore I perceive that [there is] nothing better, than that a man should rejoice in his own works; for that [is] his portion: for who shall bring him to see what shall be after him?
Ecclesiastes 3 (KJV)


Over the next few days I'll be at a family practise conference in French Lick. I may or may not have Internet access. What I will have, however, is some time to absorb and consider the events of the last few days; time I desperately need. Bear with me, O Best Beloved, and I'm sure in time I'll have for you the bright tales and patient stories that have previously been my lot. Bear and learn, if you will.

now feeling:: drained drained

1 whisper echoes . o O ( ... ) O o . whisper a word
Comments
chaosgoose From: chaosgoose Date: July 23rd, 2003 10:29 pm (UTC) (etched in stone)

hmm


there's no greater feeling than helping someone in need
yet no feeling worse than being helpless in the face of it

your job makes me half envious and half terrified

it's a confusing combination
and one that deserves more vacation time
and a hot tub
1 whisper echoes . o O ( ... ) O o . whisper a word