step out

The other day I was with my new team when we got a surprising call to a patient's room. As teams go, I like this new one; the Attending is much more efficient and likes to teach, my interns are chill and helpful, and one of my seniors is a crazy-woman in a funny way. The other is one of the most complex people I've met yet---I can't tell whether to laugh with her or be scared shitless. She is an amazing doc; yet super-down-to-business and intimidating. She talks and you listen. And yet she sometimes lets this super-dorky and funny side out that's ultimately redeeming. Plus she's pregnant. And I think it's funny to be scared by a small pregnant woman.

So. The other day I was with my team in a patient's room to which we were called for unexpected reasons. Here lays a woman in status epilepticus--constant seizure as noted by EEG. Not twitching all over the place, just extremely out of it other than intermittent moans. Her breathing oscillates between what I'd call comfortable and what I'd call labored---Cheney-Stokes respiration; your next assignment is to look that up. This woman has multiple abnormalities going on. And all week her many children had given us many different impressions. But the man in the room was the oldest, and the power of attourney. And he called us in to tell us that she was going to be comfort-care only now at home.

The guy kept referring to how he'd been in a higher rank in the Army (officer? general? I never know my ranks---Dad'd be upset with me). He said, "When you're out there, with your men, you make the decision and you stick with it. You don't look back. I never knew this decision would be so hard---so emotional. But she told me she never wanted to be on a ventilator, never be a vegetable. I have to respect that....This is so hard..."

Everyone else on my team was standing and listening with understanding looks. I kept restraining myself from the urge to push past the many bodies in the room and hug the man. The Attending reassured him that from a medical standpoint, this was going to be best for her. Then we discussed what lines to pull, which to stay; all the technicalities that will make it easier to die comfortably.

How were these people not bawling? The guy was choking up. My intern touched his shoulder.

When my team left the room, moving on to the next patient, I hurriedly excused myself to the bathroom. And there I wept uncontrollably for a good 3 minutes, and then I composed myself.

I realize that this is commonplace to my team. But it isn't yet commonplace to me. I couldn't stop thinking about my grandparents, my own parents, how I'd feel if it was my mother sitting there unresponsive with frightening breathing patterns. Later I discussed it with my intern in the computer room, on some downtime. He said at the end of the day you have to find ways to remember that most of the people in the world are healthy and living their lives out there.

The fact that I someday will be able to just turn emotions off and switch to the next task almost immediately is strange. Almost scary.

I don't think death will ever be commonplace for me. At least I don't want it to be. Only time will tell.