I keep a spare set of scrubs in my car. It’s an act of preparedness, informed by experience. A couple of months ago, I came out of an ED room after performing a particularly unsavory procedure and noticed that my left knee was wet. Disgusted, I shared my misfortune with my coworkers, and all of them had the same sympathetic response; they mirrored my grimace and cautiously offered hope: “Maybe it’s just urine.”
Urine! What a comforting thought. Urine is (usually) sterile, so I gratefully embraced that optimistic yet plausible narrative and finished my shift.
I called my mom on my way home from work and told her about my day.
“Why didn’t you change clothes?!” she squawked.
“Oh, well, I didn’t have any spare scrubs, and I think maybe it was just urine,” I responded defensively.
“That’s gross,” she replied.
I suppose it is.
That night, as I switched the setting on my washing machine from “warm” to “hot,” I wondered how I found myself in an occupation where my best-case scenario assumes that someone peed on my outfit. Why do I even do this? This job is hard. It’s chaotic. It’s stressful. It’s suspenseful. There is no closure. People curse a lot. I want a Circadian rhythm. I don’t get a lunch break. I deal with a lot of literal and figurative feces. This is probably not urine on my pants.
“Maybe it was hand sanitizer.”
My husband startled me out of my pity spiral. He is a dreamer. He is consistently and tenaciously optimistic. I know and love this about him. It is insufferable.
“Hand sanitizer?” I was almost offended. “Urine is a whimsical dream, I know, but to hope for hand sanitizer is just naïve! How would I even get that on my knee?”
Like I said, his optimism is insufferable, so don’t tell him that I dripped hand sanitizer on my knee while leaving a patient room the next day.
In the ED, we spend a lot of time thinking about worst-case scenarios. In general, it’s the ED’s job to identify or rule out crises. We plan for the worst, so we can be prepared to handle it. It’s important, and it’s a skill that I am proud to be learning. But I think I’ve let myself become so governed by the fear of the bad that sometimes I fail to recognize the prevalence of the benign, and I dare not even hope for the good. It’s true of the way I view pathology, and it’s true of the way I view the medical system as a whole. It’s exhausting — especially because the bad is present and significant and cannot be ignored. Burnout is higher in the ED than anywhere else in medicine. The reasons for that are complex, multifactorial, and variable, and there are people much smarter than I who would love to explain them to you. Regardless, my wet knee informed me that I am letting those challenges steal my joy and my hope. And that’s a pity because this field needs a rebellion, and “rebellions are built on hope.”
So in homage to my favorite Rebellion, I am committed to going Rogue (One). I will fight cynicism as insufferably as my husband. I will search out and celebrate the joys of this work. If I can’t find a joy to celebrate, I will create one. And when I need a bit more of a literal reminder, I will carve the Millennium Falcon out of Rice Krispies treats and bring it to work.
But I will also still keep extra scrubs in my car.
Rachel Matar is a physician assistant and a medical advisory board member, Lightning Bolt Solutions.
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