It’s been a busy week of evening shifts, working from 4 pm to 1 am and home by 2, asleep by 3, up at 6.  Doing this four times so far in the last six days has completely wiped me out, but the daytimes spent in the sun and with my kids have helped bring some joy to the mix.  Working so much with so little down time and minimal sleep does unfortunately affect how one approaches cases at work; picking up a new chart often feels like lifting a leaden object that I would rather just leave alone.  Never mind the negative vibes I feel, the resentment, leaving my home yet again on a summer afternoon to take care of other people when all I want to do is take care of my kids and myself.

 

Walking into the department with this angst in my heart, I enter the locker room, strip and pull on my scrubs.  I become someone else, the other version of me, the Physician.  I have described this before in my writing; the sensation of snakeskin, a smokescreen I conjure to Become another self.  It calms me, helps reduce the frustration, as I sling my stethoscope around my neck and fill my pockets with what I need for the day.  I take a moment, breathe, center, and reframe.

 

I walk from the quiet into the chaos and am met with hellos and smiles, colleagues, nurses and even sometimes patients from the day before all greeting me.  This feeling of friendship and collegiality pulls me higher out of the lake of regret in which I have been wading, wishing I were home with my kids.  The faces of patients expectantly waiting to be treated remind me why I am here.

 

Every now and then I meet someone who makes my doctor day worth doing.

 

A little while ago, I met one, a young woman who should have been enjoying her youth, waiting in a room for me to assess.  On my approach she was sitting in the stretcher with a cervical collar on her neck, when she should have been lying flat after a significant trauma.  Without much emotion she described to me how in her work as an exotic dancer, she was assaulted by a client who wanted sexual services.  When she denied this, he picked her up and threw her into a table behind her; she slammed her head, neck and upper back and lost consciousness briefly.  A friend saved her.  She had a persistent headache and neck pain so came to the ED.  After a thorough, gentle examination I quietly asked her if she has any social support.  She began to cry, admitting that she has no one.  No family, minimal friends, she lives alone and has no one to turn to in times of need.  I asked her if I could help find her support, e.g. with social services, or if she wanted to report this to the police.  She declined, as I expected.  Girls like this, so beautiful, so fragile, so vulnerable, they usually refuse the help offered.  It breaks my heart; she is someone’s daughter, and even if not appreciated by a parent, she is a soul, a person, and she matters.

 

Even in my line of work, where I see awful things often, it still shocks me that a person can harm someone else intentionally.  Call me naïve, innocent, idealistic, but I don’t understand how a man would pick up a woman and throw her into furniture.

I say this, but then intrusive thoughts make their way to the forefront and remind me of the unstable angry men I often see in my emergency department.  I have met scary people; men (and sometimes women) that I would run from if encountered on the street.  This young woman works in a place that exposes her to harm, and as a physician, there is nothing in my power to help prevent pain to her in the future.  All I could do when she was in my emerg, was keep her safe for a few hours; give her support and succor until she decided she wanted to leave.  I gave her a stretcher, pain medications, a blanket, and an ear to listen.
Tonight, tomorrow night, she may get harmed again or worse.  It pains me, as a doctor, a woman and a mother, but her choice is her choice.  Her life is her life.  I only wish the best for her and hope for her one day to get out of the life she is in and into a safer one.

 

So, coming to work even when work is the last thing I want to do, is important.  It teaches me, it opens my eyes.  It takes me out of my existence and into the lives of others; it gives me compassion and understanding.  It reminds me that there is so much more going on in this world than most of us see; there are so many layers, so many spaces, so many worlds within worlds that we as physicians are privileged to witness.  It might hurt, it might change us in ways we don’t expect, it may gnaw at our insides when we see the pain that is experienced by others.  But it can also enlighten, and brighten, and enlarge our souls.  For that, I thank this work, and the heavy load that it sets on my heart.  Without it, I would not be me, and my children would not learn what I, and only I, can teach them.

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