Being a doctor in a time of crisis

I was sitting in the resident workroom at Massachusetts General Hospital (MGH) when my co-resident showed me the text from her sister: two explosions had shaken the finish line of the Boston marathon. Though news sites had not yet published the headline, it was immediately corroborated by the cacophonic wails of ambulances heading towards us and our shock was quickly replaced by the urge to learn more and to do something. We scrolled through the emergency department’s internal log and saw with horror as patient after patient entered with the chief complaint of “amputation.” We made our way to the residency office to report our availability to pitch in, passing orthopedic residents called in to help and sharing the elevator with a case manager frantically wheeling one of several patients to another part of the hospital to make space in the emergency department (ED) for the expected deluge of injured runners and onlookers.

A few of us were recruited to help clear out the ED by expediting hospital admissions for patients with medical problems like pneumonia or heart failure. Other internal medicine residents continued their usual - now busier - work on the floors. Those, like me, on elective stayed close by in the off chance we were needed. We huddled in the resident lounge, checking in with our families and friends, scanning the ED log, and reading out loud Twitter updates filtered by source credibility. We bemoaned our internal medicine training - we could treat a heart attack but were useless when it came to mangled limbs - and shared our magnified respect for our colleagues in surgery and emergency medicine.

In the days that followed, I felt a dizzying mix of emotions, like so many in Boston and, really, across the United States. I read and watched news and commentary on the bombings obsessively, refreshing Twitter every 30 seconds, as if by internalizing every last update I could gain some control over the utterly confusing and horrifying event that had occurred in my backyard. I felt numb, and I felt guilty for feeling numb - who was I to be affected by this tragedy, compared to the families of those who had perished and the nearly 200 who had suffered often life-altering injuries? I cringed at texts and emails from friends and family commending me for my assumed heroism as an MGH physician, when those tributes were deserved instead by the brave first responders who defied human instinct to run toward the blasts and by the steady-handed doctors and nurses who took over that care.

I was startled then bizarrely comforted by the constant presence military police with long guns standing guard outside my apartment building and along my walk to work. I was awed by the courage and resilience of people in other countries who live with this reality every day. But more than anything, I felt enormous pride for the salty, sports-obsessed, brilliant city I have called home for the past twelve years: for the marathoners who completed the race only to continue running to our blood banks to donate; for the magnificently coordinated effort of Boston’s hospitals that mitigated the bombs’ devastating toll; for the unnamed police officer who delivered milk to a locked-in Watertown family with small children; and for the palpable leadership of Governor Patrick, Mayor Menino, and law enforcement officials at a time when it was so desperately needed.

On Saturday, after the death of one suspect and the capture of the second had brought some closure to the week’s surreal events, our residency program leaders brought us together for lunch and reflection. We sat in a clumsily large circle (in a theme that had been repeated throughout the week, many more showed up than expected) and talked about what it had meant to be doctors in this time of crisis. Most of us had not been able to mitigate our profound sense of helplessness in the way we knew best: by working to care for the victims. In a rare moment of vulnerability, we acknowledged to each other and to ourselves that we too had been hurt by this attack on our city. And then we stood up to return to work - to some sense of normalcy.

Ishani Ganguli is a journalist and an internal medicine-primary care resident who blogs at The Boston Globe’s Short White Coat, where this article originally appeared. 

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