The Breaking Point

And here it is. The requisite night of insanity in the medical ICU, with several patients on the brink of life and death. To be caught in the middle of it all is beyond overwhelming – the memories alone bring tears. Because all I want to do, at the end of the day, is save everyone. Everyone, that is, except myself. I called a stranger today, the sister of one of my patients, to let her know that her sister was dying. I spoke frankly with a patient’s wife today about his overall poor prognosis due to lung disease which we have not been able to make better. These conversations are hard on me, but I am always amazed by the gratitude I receive from families as the bearer of bad news – they are almost relieved to have the truth told to them, out in the open. Not that I was ever one to be good at this outside the hospital. The other thing that struck me last night was the presence of a familiar face – someone returned from the past – who happens to be connected to one of my patients. I am sure it is not a coincidence. It is one of those moments that shakes you to the bone, reminds you that what we do every day is personal, in spite of the distance that we try to achieve. It is more than personal – it is intimate. And to be intimate with a family at a critical time of illness is a privilege and a burden. It makes me think of how far I have come in all these years…from an idealistic, passionate high school student to a drained, bordering-on-cynical, but still somehow hopeful resident. I wonder at all the changes that have taken place, most of which I have not even begun to process.

There is always a day like this in the unit, and sometimes there are many days like this…they are rich in adrenaline, intellect, and chaos…and it is only in looking back that I can truly comprehend their value. They make all of the other days bearable, even enjoyable. And they remind me how fortunate I am to be in the white coat rather than the blue gown – but we will all end up in the blue gown at some point in our lives. I only hope that I can be the white coat whom I myself would want at the bedside if I were caught on the other side of the fence.


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