It was December and I was on my pediatric surgery rotation, which made those dark, gray mornings seem even lonelier. Yet I found comfort in my 4:15am commutes to the Children's Hospital. Some mornings, I let the thick silence percolate around me and marveled that I was the only one on the road. Some mornings, I blared bad hip-hop and Miley Cyrus and created an internal soundtrack for the long work day ahead of me. That month, most of the sunlight I saw was filtered through the tall windows that flanked the hallways of the hospital.
It was a Friday night. After a 15-hour day at the Children's Hospital, I was headed out the door for an overnight shift in the trauma bay at Grady, a public hospital and the only Level 1 trauma center within 100 miles of metro Atlanta. Then the surgery consult phone rang. A trauma was coming in: 10 year old kid in a car wreck. I watched the trauma team of nurses, ER physicians, pediatric surgeons and auxiliary staff efficiently manage the chaotic scene. No family member was with the scared and crying child.
Once his fractured leg was stabilized, I quietly slipped out the door to make it to my Grady shift for the adult traumas. Once I arrived, a resident sent me directly to the interventional radiology suite. It looked like the set of a horror film; there was blood everywhere. A female patient lay unmoving on the table as bag after bag of blood was infused into her, unable to keep up with the massive amount she was losing directly onto the table and the floor. They failed to find the site of the bleeding in order to stent the vessel and staunch the blood loss and she was taken to the OR.
As they wheeled her out, I sat in front of a blank computer screen as adrenaline coursed through my body. I was trying to remember the vasculature tree of the pelvis and lower extremities while simultaneously feeling shell-shocked by the violent and gruesome scene I had just witnessed. One of the residents showed me a clip from that afternoon's local news broadcast. Our patient's car had been hit head-on by a car going full-speed - the wrong way - in her lane.
I saw her again as she was wheeled to her room in the surgical ICU. Her abdomen had been left open, wrapped in plastic, to contain the massive swelling and I was told to repack it. It was all so surreal and intimate, pulling out blood-soaked towels and sponges as well as giant clots from inside this stranger's body. Her husband and parents hovered at the door - watching, crying and shaking - as multiple codes were run. The medical team pulled the family aside to discuss the precarious situation; she was unstable and likely not going to make it through the night. What were the family's wishes?
Her mother dropped to her knees and emitted a long and loud wail from deep within. I looked away so that the other medical student wouldn't see the tears streaming down my face. Through her cries, I pieced the story together. Our patient, this 35 year old female, was the mother of the boy with the broken leg from the Children's Hospital. Half of the family was at Grady with the mother and half was across town with her son. The boy would make it through the night, but his mother did not.
It was the middle of the night, but I called my own mother: to tell her that I loved her. Verbal declarations of love do not happen often in my family but I felt vulnerable, scared and raw. I needed to say it out loud, even if she already knew it.
Over the next week, our team at the Children's Hospital took care of that young boy as his leg healed. I suspect that he was only beginning the real healing process though. I thought about how this would be his first holiday without his mother. I wondered if Christmas would forever be a time of sadness for him.
I felt like an intruder, allowed to witness this family's pain and trauma, from the Children's Hospital to Grady and back to the Children's Hospital. I'm not sure this was the kind of continuity of care I was expecting.
*****
I dug this draft out of the archives, which I had saved from over a year ago.
