Your son is dead. How will you remember me?

I introduced myself to the family sitting anxiously in the private room away from the chaotic symphony of beeping monitors in the main ER. When I opened the door, four pairs of bewildered eyes landed squarely and intensely on me. I wanted to look away so as not to betray my own emotions but instead stepped in and introduced myself again — one by one making eye contact. After a brief assessment of the landscape of relationships in the room and how much they knew, I was ready to deliver the update. Their husband, father, and family friend was dead. They had done all they could do to get him to us as quickly as possible. We had done all we could to save him. But he was dead. He would never again share a knowing glance with his wife or show up at his grandson’s baseball game.

This is where helplessness and senselessness live, intersecting on the spectrum of failure in what we do. But opposite of another extreme of failure in the ER is the one more often shared — mistakes or unintended consequences that culminate in a bad outcome. Fingers pointing out the things we work hard to prevent — a medication side effect, the wrong dose, an incorrect diagnosis, a lethal mistake. Or a human being reduced to facts quoted in a morbidity and mortality conference or a malpractice suit.

This was different — uninhibited pooling of advanced resources and strong teamwork to save a life. But death won anyway, creating a moment for which there was no one person or process to blame in a profession that has a low tolerance for failure of any sort. What happened, happened. And what we could offer — a team of highly qualified doctors and nurses who followed a standard of care — wasn’t good enough.

Over the years my job in the ER has thrust me into thousands of enduring positive and negative memories, but I will never forget how hard our conversation was. How you became physically ill before I could finish my sentence. How your sister couldn’t process that her father was gone until I said it … dead.

Will you remember me as soft-spoken? Did you feel my frustration or helplessness? Will I become part of your recurring nightmares or drift into my rightful place in the background of your mind? When I awakened you that night to tell you that your 17-year-old son was shot in the head, will you recall that my voice almost cracked? A pleasant introduction coupled with a whirlwind of emotions. My voice, my posture, my words. Breaking bad news repeatedly? Silent acts of torment?

How will you remember me?

Leigh-Ann J. Webb is an emergency physician and can be reached on Twitter @Leighwebb_MD.

Image credit: Shutterstock.com

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