Tuesday, January 29, 2008

On Another's Sorrow

Can I see a falling tear,
And not feel my sorrow's share?

As the intern year has gone on, compassion has been harder to feel, and later, even to fake. Patients mean work, and when your work is this draining and frustrating, the real people behind the mountains of paperwork become frustrating.

All this was put into perspective last night. I was on call, shambling back and forth with as much celerity as I could muster at 2am, when the overhead intercom burst forth with "Attention in the hospital, code blue, labor and delivery, room 9."

Codes are never easy to deal with, but with most of the geriatric medicine codes I've seen, there is a sense of resignation despite the furious efforts. After all, there are very few 85 year olds who will make anything like a full recovery after two minutes of CPR. A code on L&D is a different matter entirely.

When I arrived, the anesthesia and surgery teams who work on the same floor had unsurprisingly beaten my two-floors-of-stairs-sprint to the scene. I stayed just long enough to get a general idea of what had happened from one of the residents, and then I turned to go back to my work. The patient had HELLP syndrome, a rare but not unheard of complication of pregnancy, and had coded shortly after a crash c-section.

Walking out through the waiting room, I ran into the woman's husband. He was scared, worried, and completely in the dark. His first question was "how is Susan?" His second was "what does code blue mean?" Realizing his need, I started talking to him, answering what questions I could, both as a physician and as someone who genuinely cared.

And that was the shock. I realized, despite the bitterness, despite the pain, despite everything that over the last few months has brought so many undesirable characteristics to the fore in my personality, I did care. I'm not sure anyone who hasn't gone through a similar situation can fully understand this. The point of it was, I really did care, I do care, and though I am saddened to know it took something so extreme to remind me of it, I am enheartened that I have been reminded.

He becomes a man of woe,
He doth feel the sorrow too.


Doc's Girl said...

I hear ya...it's extremely tough not to feel in that situation.

I'm a volunteer at a hospital where I spend my time (3-4 days a week) with kids primarily and...I come home many nights upset, sad, and just plain angry at the world...because I do care.

You are very lucky in your position that you can answer important questions for family members. I would try to focus on that much...

I wish that I could offer more help in my position but I have to remember that it, too, is a pretty heavy burden to carry. I'm quite lucky that I just play with the kids...and not be the one to give them any good or bad news.

~Denise~ said...

Thank you for your work.


Anonymous said...

That's an awful story. But, on the other hand, in the delivery room surrounded by anesthetists and doctors is probably one of the most survivable places to code. Did you find out what happened to her?

Nathan said...

doc's girl - I admire your strength. Part of why I stayed out of peds was my inability to deal with sick kids.

denise - you are quite welcome, and thanks for stopping by.

alice - I did. Unfortunately, she has not done well.

Doc's Girl said...

Funny for you to mention that. :)

I didn't have any plans on pediatrics...and, unfortunately (not that all of my experiences have been bad, some have been so powerful, funny, and life changing), volunteering at this hospital further enforces that.

Liana said...

I can't believe I've never stumbled across your blog before. I really like it. A lot of your posts remind me of what I aspire to on my own blog. I'll be back.