Working in a level one trauma center can be very emotional. Some of the emotions we feel, don’t even have words to describe them. The emotional triggers are frequent and diverse. In the short span of a twelve hour shift our minds sift through a vast and enormous array of emotions. Here, I’ve made a feeble attempt to create a vehicle for you to explore a twelve hour shift with me…
- Sorrow – As I kneeled on the floor beside my patient’s bed, I held her hand as she cried and I cried too.
- Amused – As a patient used humor to cope with his own follies that landed him in the emergency room.
- Concern – Over a co-workers uncharacteristic snippy attitude, because I knew she must be having a very bad day for some reason.
- Fear – Because I have to be perfect. Because as a team, eight of my co-workers and I have to be perfect together. Simultaneously perfect. Because if we are not precisely perfect for the next three minutes, this very small frail patient will die.
- Relief – Because we are precisely perfect together, and because we are precisely perfect together, a child will live.
- Dread – When I hear all of our trauma pagers alarm at the same time. It means somebody is hurt very badly and they will be arriving at our emergency room very soon.
- Apprehensive – Because I have a new patient arriving in the emergency room soon. However, I can’t leave the patient I’m with. If I move my thumb and index finger in the slightest way, the patient I’m touching may die.
- Computerized – Because I have to calculate time, procedures, mechanism of injury, possible injuries, the patient’s normal metabolic function, how the injuries are going to change the patient’s metabolic function, oxygen needs, cardiovascular function, and neurologic needs. I analyze data such as skin color, skin texture, breathing pattern, respiratory rate, pulse, blood pressure, oxygen saturation, glucose, exhaled carbon dioxide, pupil size, pupil reactions, body size, body composition. I theorize their entire life, medical history, activity level, activity type, and life style. I gauge the volume of air their body needs, how much of that air needs to be oxygen, how much pressure their lungs and heart can tolerate versus how much pressure is required to deliver that air, and the speed the air needs to be delivered. I use that information to program their life support machine and I do it in less than sixty seconds.
- Grateful – To find the Pediatric Respiratory Supervisor, taking care of my adult patient for me.
- Irritated – Because the medical student keeps getting in my way and I have to physically move him. In a trauma or code situation it is acceptable behaviour to physically move someone out of your way, if you need to do a life saving procedure and they are not doing a life saving procedure. It impedes patient care to waste time and litter the verbal communication flow with polite politically correct dialogue.
- Elated – When the very same medical student displays functional mental and physical abilities under extreme stress, that help me to do my job more efficiently.
- Disgust – At the self destructive nature of humanity.
- Guilt – For feeling disgusted.
- Pride – As one of our newer residents masters a skill that will enable her to save countless lives.
- Stupefied – Because a visitor thinks that making a phone call in the middle of the RESTRICTED ACCESS EMERGENCY TRAUMA HALL WAY is more important than the dying patient that needs to be transported through said hallway to the emergency room.
- Even more stupefied (if that’s possible) – When said visitor treats me like an insolent rude little street urchin when I politely direct her to the comfortable and spacious VISITOR WAITING ROOM.
- Worried – As I phone a co-worker and ask him to take care of my patient on the floor, hold a conversation with a doctor, and help safely move a patient from the CT scanner table back onto the emergency room stretcher, all at the same time.
- Relieved – To see my supervisor at the doorway. I’m performing CPR. He’s come to check on me and make sure my other patients are OK.
- Calm – Because I have to be.
- Helpless – As I watch two girls say goodbye to their father for the very last time.
- Patient – As I call the Chaplain. I have to keep repeating myself because she’s groggy from sleep. After all, I woke her up at four AM to ask her to come console a grieving family.
- Amazed – I haven’t had to pee in the past ten hours.
- Silly – Because I realize that I haven’t pee’d because I haven’t nourished or hydrated my body for the past ten hours. After all, it is a little selfish to eat and drink when people are dying.
- Content – As I sit down with my co-workers at the end of the shift for an impromptu informal therapeutic decompression session. We had endured a lot in the past few hours together…
- Comforted – As my relief hugs me and tells me every thing is OK, and I can go home now.