Sometimes, the loudest sounds I hear in the emergency department are laughter. It may seem irresponsible. It may seem discordant. It may seem callous. To me, it is the sound of survival. It is the sound of resiliency. It is the sound of making it through the day.
My father was at work when he suddenly became cold, clammy, and collapsed to the ground unresponsive. His staff did the right thing and called 911. He was rushed by ambulance to the emergency department. He had vital signs taken, an EKG done, and blood work drawn. It was an experience that shook my family. My dad, on the other hand, was exasperated. He minimizes his health and upon arriving to the emergency department, was already scheming ways to get himself discharged. He had no such luck, and was ultimately admitted for further monitoring and testing. Today, he is back to his healthy self, and doing well.
I remember speaking with my father while he was in the emergency department. He commented, “All these people. Bunch of jokesters. Everything is a joke!” I could tell he appreciated it. He is not one for dramatics, and their sense of humor helped him get through that visit. It helped me too. It made me feel he was in familiar territory, that culture of humor that pervades all emergency departments across the nation.
It may seem like a strange place to hear laughter. But here is the thing. Working in the emergency department is more emotionally draining than I could ever have fathomed. No matter how high of spirits you are in when you walk in the door, the day will wear you down. You keep up your coat of armor; you navigate the fires, but inside, you feel yourself being broken down. It comes from all directions. It comes from the deepest sadness of sharing bad news with your patients. It comes from the confrontational situations you never wish you were in to begin with. It comes from the stress of hoping that everything is going to turn out okay in a way that will comfort your patients and their loved ones. It comes from the pressure of working fast, the responsibility of not missing any one thing, juggling too many tasks to count at one time. My words could never give that heavy pit in the stomach that follows us through the day true justice.
And so how do we cope? We laugh. We joke. We check in with one another through everyday banter to ensure that we are all still okay. It is the only lighthearted part of our days, and I assure you, we need it to get through. No day for us is a typical day. We are sharing in some of our patients’ lowest moments. We are here to provide support, to provide comfort, we are here to absorb it all, and ultimately, we find our own ways to release what we put on our shoulders. If we allowed ourselves to be consumed by our stress and our sadness from each moment, we just couldn’t come back and do what we do tomorrow.
So. I ask you. Please forgive us if our loud voices and laughter seem callous. Please know it is the opposite of that. It fuels our resiliency; it allows us to take care of the revolving door of patients coming in and out of our emergency department. It allows us to bounce back; it is our way to decompress and destress and face the next challenge of our days with the renewed energy and compassion that we need to get through today in the healthiest way possible.
Cindy Winebrenner is an emergency physician who blogs at Mom-Wife-Doctor Thoughts.
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