I saw him soon thereafter, and shook his hand, and told all his family the next time we get together let’s do it someplace besides the ER since that always lightens the mood with people you only kind of know. As I started my assessment it soon became clear that he had something VERY BAD. I ordered a series of tests to show the BAD and quantify how VERY, placing some calls to make sure they were done as soon as possible
A bystander might wonder how an ER can be so devoid of empathy, how we can be unaffected by and in fact make light of disease and suffering and death. The reason is that it’s impersonal, that we interact with you but don’t know you, that the fact of the matter is unless something is particularly tragic some sort of an interpersonal connection is necessary to conjure up grief. It’s the difference between reading an AP story of another soldier’s death, then watching a sit-down interview with his decimated wife and kids.
I’ve been cognizant of my emotional detachment for some time now, but never really appreciated its benefits until I worked without it. I’ve taken care of friends and acquaintances before, but always for some relatively minor ailment. But now here was my neighbor, and his VERY BAD findings. No longer was I able to run the department expertly, only adequately, since I was spending far too much time perseverating on him. He had a few different treatment options, his accompanying co-morbidities causing each choice to carry a substantial countering risk. I second guessed myself far longer than I normally would, continually revisited and reupdated his family, and had a persistant underlying sense of unease and jitteriness — all because I had a small but legitimate fear that he would tip over some ill-defined physiologic precipice and die in front of me, his house becoming my permanent reminder of his family’s grief, my house turning into a monument of failure and shortcoming to his widow.
Finally he was gone from the ER, as stable as possible, and at least if something happened now I’d be off the hook for it. As it was, he went on to make a full recovery. He now credits me for saving his life, and while my emotional side is plenty willing to soak that up, my more insistant logical side knows his diagnosis couldn’t have been more obvious, that sometimes a patient’s fate is set, one way or the other, regardless of this or that treatment thrown at them, that as an ER doc it doesn’t feel like you’ve done anything extraordinary unless you, well, do something extraordinary — certainly not just see over some case that anyone, save for a complete hack, would be unable to bungle.
Still, I’m so glad you’re ok neighbor, for both you and for me. Next time we get together let’s do it someplace besides the ER
A bystander might wonder how an ER can be so devoid of empathy, how we can be unaffected by and in fact make light of disease and suffering and death. The reason is that it’s impersonal, that we interact with you but don’t know you, that the fact of the matter is unless something is particularly tragic some sort of an interpersonal connection is necessary to conjure up grief. It’s the difference between reading an AP story of another soldier’s death, then watching a sit-down interview with his decimated wife and kids.
I’ve been cognizant of my emotional detachment for some time now, but never really appreciated its benefits until I worked without it. I’ve taken care of friends and acquaintances before, but always for some relatively minor ailment. But now here was my neighbor, and his VERY BAD findings. No longer was I able to run the department expertly, only adequately, since I was spending far too much time perseverating on him. He had a few different treatment options, his accompanying co-morbidities causing each choice to carry a substantial countering risk. I second guessed myself far longer than I normally would, continually revisited and reupdated his family, and had a persistant underlying sense of unease and jitteriness — all because I had a small but legitimate fear that he would tip over some ill-defined physiologic precipice and die in front of me, his house becoming my permanent reminder of his family’s grief, my house turning into a monument of failure and shortcoming to his widow.
Finally he was gone from the ER, as stable as possible, and at least if something happened now I’d be off the hook for it. As it was, he went on to make a full recovery. He now credits me for saving his life, and while my emotional side is plenty willing to soak that up, my more insistant logical side knows his diagnosis couldn’t have been more obvious, that sometimes a patient’s fate is set, one way or the other, regardless of this or that treatment thrown at them, that as an ER doc it doesn’t feel like you’ve done anything extraordinary unless you, well, do something extraordinary — certainly not just see over some case that anyone, save for a complete hack, would be unable to bungle.
Still, I’m so glad you’re ok neighbor, for both you and for me. Next time we get together let’s do it someplace besides the ER
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