Friday, April 10, 2015
The viral picture of a doctor grieving after a patient died resonated with me. The loss was palpable; the helplessness was disturbing. It has struck a chord in every other person who works in the medical field. A poignant image that happens all the time, it is replicated in the privacy of the staff lounges, in the restrooms, in the offices, anywhere nurses and doctors are able to escape for a few moments to grieve.
I have cried many times in my nursing career. For those we have lost and those we cannot help.
I spent my first four years in the US in a chronic care hospital in Roosevelt Island in New York. My first patient death experience was an end-stage renal disease patient who suffered a cardiac arrest. The other nurses who helped me do the post-mortem care were as distraught as me. Our tears mingled with the bath water as we washed the patient’s uremic skin and combed her gray matted hair.
There were more patients in that unit who died after her. The patients were our family… and every time one passed away, we cried with the rest of the staff. Most of the time, the nurses were the only ones who mourned their passing because the families had long abandoned the patients.
When I started to work in the emergency department, I taught myself to be stoic. It was my shield against the pain of tragic loss, my armor to protect my heart from shredding whenever a patient died. I could not afford to be burned-out. The compassion and empathy remained, but breaking down in tears is something I avoided.
Death is a constant in the emergency room. Some of those deaths were hard and brutal, unexpected and difficult to accept. However, there were some deaths that were almost a welcome event, especially for those chronically-ill patients who lived through extreme pain. For them, death released them from hell on earth.
Every so often, something pierced through the thick armor I built around my emotions.
I cried for one young man who came in traumatic arrest after a motorcycle crash.
I cried with a wife and her son when the patient died after they signed the Do Not Resuscitate papers.
I cried when the cardiac ultrasound revealed no cardiac activity. The patient was one of our own nurses who came in cardiac arrest after collapsing on her way in to work.
I cried with the elderly husband who grieved for his wife of fifty years.
I cried when a six-month old baby drowned in bath water.
I cried with the nursing staff when one of our favorite “regular’ drunks died from hypothermia.
I cried when the seventy-year old woman who swallowed cocaine bags to earn money for her daughter’s cancer treatment died on the way to the OR.
I cried when a young pregnant mother succumbed to her injuries after she was struck down by a forklift. I cried for her baby who survived but had brain damage.
After I cried, I went back to work. Such is the life of those who work in the medical field. There is always someone who needs our help, someone who needs his Dilaudid. Breathe in, breathe out. There was not enough time to lament the loss of life because there are so many more who need our attention.
But there are also times when I cried for joy.
Many years ago, a boy was hit in the middle of his chest with a baseball. He went into cardiac arrest, in commotio cordis, and was rushed to the OR. Three weeks later, the boy returned to the ED with his mom to thank the ED and surgical staff for the heroic efforts of saving him. The boy named Pedro beamed as he was surrounded by weeping nurses.
There are many moments of happiness in the midst of the darkness in the medical world. We have saved many patients, eased the sufferings of those we cannot save, and touched many lives along the way. Caring for someone does have many rewards.