My patient was brought by EMS after a respiratory, and subsequent cardiac, arrest. She could not be intubated in the field, and I did so on her arrival. We actually restored some circulation, albeit not much. Over the course of an hour, despite our best efforts, she became blue again, with lividity pooling in her flanks. I had spoken with her husband over and over, and he knew that the situation was grim.
It was just after Thanksgiving, and he was wearing Christmas sweatshirt. His family was gathered all around, as families do, especially here in the South.
We decided that it was time to stop. That she had, in essence, already died. That we were only supporting a shell. The family cried as we escorted them to the bedside before we stopped everything.
It was a busy night. All around were university students sleeping off their alcohol, consumed during a football game. There was flu, there were colds, there were ankle sprains.
And it struck me, as I walked from a family’s nightmare to a college girl’s injury, and then to an obnoxious 19-year-old drunk (facing the wrath of his extremely angry mother), that this is a serious emotional roller coaster.
To laugh with one patient, comfort another, save another and lose another, to mourn and to smile all in the span of some 20 minutes is a bumpy ride.
We ask, of burnout, “why is it happening?” We ask why physicians leave the specialty. Is it money? Is it lack of education? Is it insufficient empathy? Is it alcohol or priorities?
I think it may be this. That we see too many extremes in the course of our days, and have to meet each one with appropriate skill and proper emotion. And we have to little time to process any of it.
I used to like roller-coasters. I’m older now, and I can’t handle the twists and turns as well.
Not even in amusement parks.
Edwin Leap is an emergency physician who blogs at edwinleap.com and is the author of The Practice Test.
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