A Day in the Life

You walk into the room and introduce yourself to a young woman. Another stranger meeting a stranger. She looks scared, or maybe just worried. She doesn’t want to be here but thinks she should be because she doesn’t understand her discomfort. She’s never been here before and she doesn’t know that you’ve already been in this room three times today with three different strangers. You glance at the numbers which reaffirm your initial impressions, then you crack a small joke to break the ice. You have less than a minute to get her to trust you - a stranger - with her life. The joke works. You proceed with the standard routine and she starts to trust you. If the joke doesn’t work, often a gentle touch is all that’s needed. But this time the joke works. She smiles as you leave the room. She’ll be able to leave the room soon, too. But you know you’ll probably be back there within the hour to meet a new stranger. You check your watch. Only 90 minutes until you can go home.

For now, it’s back to the paperwork. So much paperwork. It’s mostly digital now, which makes things go faster, but for a “paperless” system, they sure do waste a lot of paper. You might be able to get this one done quickly since things went smoothly with the young woman. Yes. No interruptions, so now you have one less item for your ever-growing to-do list of paperless paperwork. That gives you some time to work on finishing another one before you have to go to—no…you’re handed a piece of paper that you must look at. A quick glance and you know that this tracing is fine and that person can wait for a while. Back to the “paperwork” before anyone can interrup—another piece of paper is thrust in front of you. Another quick glance. This time you see something that concerns you. You redirect your concentration to this very real piece of paper in your hands. This one looks…not normal. You ask where this person is. You head to another room to see this older gentleman.

As you walk to the room, you pass several other rooms along the way. You glance into the first: the baby is breast feeding. No more vomiting. That’s good. You peer into the second: the young man is resting comfortably. Good. Your plan is working for him. You’ll need to check his report soon. You peek into the third room and you see Walter. Walter’s back again. That’s the fifth time this week and the second today. At least he’s not bleeding this time.

You make it to the older gentleman’s room. Another stranger meeting a stranger. You look at the older gentleman and glance at his numbers. No jokes this time. This time it’s all business. Professionalism and confidence are your immediate tools. Knowledge and skills quickly follow. Then comes leadership. Your team is here. They’re all looking to you for guidance. You chuckle to yourself because most of them don’t need you to tell them what to do. They’ve all done it before and they all know what to do, but having you in the room gives them confidence. Your team works well together and soon twenty minutes have gone by. The older gentleman is more comfortable now, but still in danger. You’re told his wife is outside. You know what you need to tell her. You’ve had this conversation before. More times than you care to think about. Your team has things under control. You walk out of the room.

You walk down the hall to meet the older gentleman’s wife, but before you get to her, you are asked to come into another room quickly.

You enter this other room. No need for introductions. You know this man. Not personally, but professionally. He’s not breathing. Again. Your team already knows what to do and they get it done. The man starts breathing again. He opens his eyes and looks at you with part confusion, part hate, part sadness. You have empathy for his disease. He’s alive. Not everyone gets so lucky. You wonder how long it will be until you see him again and if the next time he won’t be so lucky.

You go back out to speak to the older gentleman’s wife, but before you get there, you’re told you’re needed in the large room in four to five minutes. You stop to take a deep breath. The conversation with the older gentleman’s wife will have to wait a little longer. You look at your watch. Only 60 minutes until you can go home.

You walk to the large room and get stopped by someone telling you the report for the young man down the hall has arrived. It’s just what you thought it was. Good. You’ll deal with that after this. Someone asks if the mother with the now-breast-feeding baby can go home. You say yes she can. You’ll deal with that after this. The man who was not breathing is yelling now. He’s angry that you gave him something and now he doesn’t feel good. You’ll deal with that after this.

You enter the large room at the same time as everyone else. No introductions needed here, but not because you know this woman. She’s another stranger. She doesn’t look good. A young girl comes in next and they put her close by in the same room. The young girl is a stranger and she is crying. She’s scared but she’s not in danger. The woman isn’t crying. She isn’t doing anything. You are told there were two others involved, but they won’t be needing your services. The young girl seems ok for now. You begin with the woman. There should be others here to help soon. Your team works hard. Others come in and start working on the woman. Good. Now you can go to the young girl. She seems ok, but you have to be sure. It doesn’t take long to confirm she is. You look over at the woman. She doesn’t seem ok. The others take the woman away. There’s no more you can do for her, but maybe the others can. Someone tells you they can stay with the young girl. You leave the room.

You walk toward the room where the older gentleman’s wife is. Someone asks if you can see a boy who can probably go home. You say you can. You look at a computer before meeting the boy and his father. Good. Nothing broken. You enter the room. Another stranger meeting strangers. The boy looks unhappy. He’s holding his left arm with his right hand. The dad looks worried. You notice the boy is wearing a shirt with dinosaurs on it. You’ve always loved dinosaurs. You ask the boy which dinosaur is his favorite. He says Tyrannosaurus Rex. You tell him that’s your favorite, too, but you also kind of like Triceratops. The boy smiles and looks at his dad who’s smiling, too. You tell them there’s nothing wrong and the boy will be ok. They’re happy. You leave the room.

You head to the room where the older gentleman’s wife waits patiently. Before you get there, you’re given another paper. This one looks fine, so you sign it and hand it back. You finally make it to the door where the older gentleman’s wife is sitting inside. You turn the handle and as you open the door, you’re told by someone hurrying towards you that you’re needed in the older gentleman’s room quickly. You acknowledge this but enter this room first. An older woman is sitting in the chair. Another stranger meeting a stranger. She has been crying, but isn’t anymore. She has been using tissues from her purse. It’s a large purse and you imagine there are other things such as sucking candies, a rosary, and a large wallet inside. She is dressed nicely. She stands up as you enter, but you ask her to sit back down. This isn’t going to be an easy conversation. You explain that her husband is dying. Your team is doing everything they can to prevent it, but it is certain that he will die tonight. She understands. She tells you they were going to celebrate their 70th wedding anniversary next week. She tells you they’ve had a happy marriage and a happy life together. She tells you she’s not ready to let him go, but she knows that’s what needs to be done. She wants to tell you more about their life together. You know you don’t have time to listen, but you let her talk. She asks if she can see him. You tell her of course she can. You look at your watch. Only 10 minutes until you can go home.

You walk out of the room with the older gentleman’s wife and lead her to her dying husband.

You see Walter walking down the hallway. He’s walking in a straight line. That’s good. He’s eating a turkey sandwich. He can probably leave soon. You enter the older gentleman’s room. Someone from your team is rhythmically pressing on his chest. He has a tube coming out of his mouth. He has tubes coming out of his arms. He doesn’t seem to mind. The older gentleman’s wife asks if she can speak to him. You tell her she can. Someone brings her a chair and she sits next to his head. Your team member continues to press on his chest. She leans in and whispers something in his ear. You can’t hear what she says. He doesn’t seem to notice. She smiles and stands up. She kisses him on the forehead. She says thank you and asks your team to stop. You tell them to stop. You look at the numbers. They are all zeros. You pronounce the older gentleman dead. You express your condolences to the older gentleman’s wife. She thanks you again. You leave the room.

You go back to your computer. There’s so much noise around you. Your colleague from down here has arrived. That’s good. She can start taking care of the others. You look at your watch. You should have gone home 20 minutes ago. You still have work to do.

You call your colleague from upstairs and wait for his reply. You send home the baby that was vomiting but isn’t any more. You send home Walter. You hope he doesn’t drink too much tonight. You send home the boy who likes dinosaurs. He was sad that he didn’t get to have a cast. You’re happy that he didn’t need a cast. You get a call back from your colleague from upstairs. You tell him about the young man with appendicitis. He says he’ll take care of it. He tells you he has just finished with the woman who was the young girl’s mother. He tells you she died from the car crash injuries. He tells you the others in the car died at the scene of the crash. You thank him for the news and wonder how you will explain to the young girl that everyone in her family is dead. You look at your watch. You should have gone home 40 minutes ago. You go to the large room.

The young girl is still there. She looks ok. She’s sitting on a chair now and another woman is with her. The other woman tells you she is the young girl’s aunt. You tell them both that the woman has died. The young girl’s aunt tells you that the woman was her sister and she starts to cry. The young girl starts to cry. You tell them that the other two in the car died as well. The young girl’s aunt tells you that those two were the father and brother of the young girl. The young girl’s aunt says that the young girl still has a family and that she will take the young girl home with her. You express your condolences. You leave the room.

You go back to your computer. You look at your watch. You should have gone home 60 minutes ago. The man who wasn’t breathing is yelling at people. He wants to leave. You tell him he can. He walks outside still wearing a gown. Everyone can see his ass.

You finish your paperless paperwork and make sure everything has been documented accurately. You look at your watch. You should have gone home 90 minutes ago. Now you can go home. You leave to go home.

You exit the building and you see Walter standing by the bus stop. He’s finishing another turkey sandwich. He sees you and waves. He thanks you for all of your help. You know you didn’t do anything for him tonight because he didn’t need any treatment. You only gave him a turkey sandwich. He walks away and waves again with the hand holding the half-eaten sandwich. You’re happy that he can walk home this time, but you know you’ll see him again within the week. You go home.

You get home. The first thing you do is take a shower. It’s important to cleanse, but also, it helps to wash away the day’s events. You put on clean, comfortable clothes and pour yourself a drink. Scotch. Single malt. Neat. You think about the day, but you don’t dwell on the specific events. Thinking too much would be unbearable.

You love your job because you impact the lives of countless people every day. Sometimes you make people happy, sometimes you don’t. Sometimes you can’t help them, sometimes you can. Sometimes all that’s needed is a turkey sandwich. You’re glad you’ve chosen this profession and you’re thankful that you were able to achieve this career. The hard days are leveraged by rewarding days and every shift is rewarded by knowing you’ve made an impact on people with every interaction. You hope these strangers will stay focused on the positive. You’ve worked another day doing everything to the best of your abilities and with the utmost professionalism for people you don’t know and who don’t know you. For strangers. You know most won’t remember or won’t care. Most won’t notice or won’t understand. But you will. And you’ll sleep well tonight. And you’ll go back tomorrow to do it again because that’s what you do. You’re an Emergency Physician.