Posted on by myblackscrubs

The Journey

I walk doggedly through an expanse that seems never-ending. All around me, the pale sands hide quiet, sleeping monsters ready to explode. Alone, I traverse this minefield, picking my steps both with determination and with caution. Alone, yet burdened, my back bent with the weight of all I am fighting for. I look around me, strategize, then go on instinct as the strategy fails me. I yearn to find the path out of this maze, to find my way to a calm space where I can be safe, my children can be safe, my world can feel safe again. I dig deep and push on, tiptoeing at times, but I force my back straight and my shoulders square and pull forth all the strength I have to go on.

I climb a sand dune, reach the top and gaze towards a horizon; in my view I unexpectedly see green. Filled with hope, I throw myself headlong down the slope, rolling chaotically downwards, my hair picking up oceans of sand as I go. Curls flying and arms flailing I reach the flat, brush myself off and try to pull myself together. I remember that things are not always as they seem in the desert, and I recenter myself. Moving forward step by eager step, I reach the area that had been green in my dreams only to find the mirage was just that: illusion. Sighing, I allow myself a few moments of desolation before swallowing the bitterness and once again finding my resolve. I knew it couldn’t have been real; such is life these days. Hope is proffered suddenly on a silver platter then just as rapidly pulled away. I have learned to understand this pattern, and though I may still fling myself headlong into the anticipation of joy, deep down I recognize that deception is more likely.

I try to remind myself, as I pilot my way through this time of my life, that this is only temporary. Though the future may seem distant, it will eventually be my present. These times of insecurity won’t last. The morass of devastation must have a boundary, and once crossed there may be vast fields of contentment. Recognizing the phantasm of an oasis at the bottom of that sand dune only reinforces my excitement for what will one day come, and I push onwards with that tiny spark lighting my way.

Posted on by myblackscrubs

Today, tomorrow, and forever

Today, I kept a woman alive who was already dead, and then I let her go.

If I could draw the scene, I would draw a picture of grief. Grief, who today, was a mother surrounded by her children, their hands lovingly on her as she lay unmoving. Their tears falling onto the sheets and hospital gown she lay in, and onto her cool skin, acknowledging the end of the life they had known together.

She was found in her kitchen this morning, and no one had seen her since the evening before. Alone, she lay there possibly for hours untended, extremely ill, the minutes ticking by into oblivion. Was she already gone before the firemen broke her ribs with CPR? Did she have any awareness or was she already an empty shell, and perhaps her soul floating, ready to untether itself?

Already intubated in the field by EMS, CPR ongoing but likelihood of survival low due to how long she had been down, I chose to continue the resuscitation until the family could come in the room to say goodbye. I had to do this, to give the family peace, to know there was truly nothing I could do to save her. It had to be done, as a means to an end, to find closure. A temporary measure, not a life-saving one. Not this time. I knew as soon as her adult children arrived and were able to hold her hand one last time, I would stop. We would let her go.

When it was time, we stopped CPR and  took out the tube. We left the room, gave the family space and time in her final moments. One of her sons held her hand, as her breathing stopped forever.

Her heart had fluttered its last beats, and I came back to the now empty room to make sure. Performing the ritual physicians do to ensure death can be pronounced, I listened to her heart and lungs – silent – and checked her corneal reflex – absent.

Time of death: 3:09 PM.

In that room with what was until moments before, a human being, I truly felt alone. I did not feel anyone else’s presence. She was gone. And I, I felt like a wraith myself as I quietly slipped back out and back to the living, to go on with the day as if this momentous thing had not just occurred.

That’s the paradox in Emergency Medicine – save a life or watch a life slip away, then walk out, go back to a full department and dozens more patients needing care. Do CPR, intubate a patient, ensure they are stable, then go and talk to a homicidal psychotic man who thinks he runs the world. Spend an hour in resus fighting death, lose the battle, then walk back out and examine a woman miscarrying her twenty week fetus, or the man with chest pain, or the teenager with a sprained ankle. Just keep moving, keep helping, keep going. Every shift.

Then leave work, and head home to the next full-time job of motherhood. Now single motherhood. I have to leave the pain and heartbreak, or the triumphs and joys, of my day at work, and shift focus completely onto preparing dinner, doing homework, getting kids to bed all while loving them and giving them all that remains of me. Oh right – and the dog. Her too. Today reminded me of this commitment, as I watched a family demonstrate love and connection until the very last moment of life.

Death life life death death death life life life life life! And it goes on, and on, and will never change.

It’s why I chose this field, why I commit myself every new day to give what I can when I can. And it’s also why I chose motherhood – to be there, every step of the way, even when I’m so tired I can barely open my eyes to help my son close his at night. This is my life, and I wouldn’t change it. The intensity of being, the drive, the passion, the reason for being alive – this is paramount. Without it, what are we? Why do we exist? There must be some reason to it all. Healing and mothering – I suppose these are my reasons.