On Friday I was walking from Point A to a rather remote Point B and I ran into one of the peds ICU docs so we walked together. (side note: I have no idea how I know the peds ICU docs because I try to stay out of that place, but for whatever reason, I've always been the type of person who knows everyone. This happened to me in med school too)
Me: Hey, is everything OK? You seem sort of...bummed.
PICU Doc: I pronounced a kiddo this morning.
Me: Oh wow. I'm sorry.
PICU Doc: His father is probably going to go to jail.
I'll spare you the details, but it was probably one of the most sickening child abuse cases I've ever heard. (And if you're in ortho, you see child abuse. And domestic violence. And elder abuse. I don't talk about it much, but I see a fair amount of it.) Not to get too graphic, but the six month old baby had multiple skull fractures and had been shaken so hard that the gray matter of the brain couldn't be differentiated from the white matter of the brain. And that was just the injuries he had to his head.*** I wound up talking down the PICU doc for a while which was a little strange since I don't really know him, but he kind of seemed like he wanted to talk.
I've also been to some really sad places lately. The other day I was doing something in the ER and one of the general trauma docs (Dr. MarineBerg) asked if I could help him for a little while because he didn't have a resident and a Tier 1 trauma was coming in. So I followed him into Trauma Room B, gowned and gloved up...and the medics brought in a dead 13 year old. Gunshot wound to the chest. Dr. MarineBerg pronounced, I left the room.
The reason I bring all this up is because I was involved in a (different) upsetting case the other week where a 20 year old guy tried to kill himself by jumping out of a building. He broke his neck, his back, both legs, both feet, one arm, and lacerated his liver and his lung. One of his ankle fractures was open so we had to go to the OR to wash it out and do what's known as "damage control orthopaedics." (DCO for short) He was hemodynamically stable, intubated, and appropriately packaged by about 22:00 so we headed up to the OR then.
I really try to not get holier than thou, but I was disgusted by the behavior of most of the OR staff. The anesthesiologist said repeatedly he wished the kid had succeeded in killing himself so we wouldn't have to operate on him now, the circulating nurse said it pissed him off that our tax dollars would likely go toward the guy's medical bills, the scrub nurse said we should just finish the job and kill him in the OR, and my attending said he couldn't understand why we were bothering to save him since he was a suicide.
I'm sorry, I'm better than that. I was raised better than to make comments about how people should kill themselves and I"m not even going to make a comment about finishing the job as a joke. That's disgusting. I know it's late at night, but that's the sacrifice you make when you go into medicine. Sometimes problems don't happen between 9 and 5. Yes, it's inconvenient, but here's someone who really, really, really needs help. Let's do this. No, it's not what i was planning on doing with my Saturday night, but it's my job and I will do it to the best of my abilities. So I wanted to tell everyone to please refrain from making comments like that, but I didn't want to come off as holier than thou. So I didn't, but I wish I had.
I am very sensitive and I worry that since this stuff upsets me to the level it does, maybe I'm not cut out for trauma. But if the peds intensive care doc can still get upset when kids die and be a damn good doctor, then it's OK for me to get upset when people get hurt.
And quite frankly, I wouldn't want it any other way.
***If it is any consolation to anyone, all of his organs were harvested. Heart, lungs, kidneys, intestines, pancreas...everything. I think there were three transplant teams working at the time.