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Monday, June 7, 2010

The ER Delivers...

Bring it ER, Bring it Med IV... That was the closing sentence in my Beginning of the End post. Excitement and ambition.

I have to say that today, the ER delivered. Today, I couldn't help but think that what was happening was some kind of response to what I wrote and felt a few days ago when I was just starting out...
The ER never faltered, even in the med III ER rotation, in showing us how little we knew, and how completely unprepared we can be for handling situations and patients beyond our qualifications.

If any Med students that are reading can relate, whenever you finish a case with good outcome, whenever you deliver proper diagnostic skills and therapeutic intervention without having to page your resident, you tend to feel unbeatable, like there's nothing that can catch you off guard, or on the back foot. You feel exactly the way I felt when I wrote that post, or the way I felt immediately after discharging the patient with a glass injury to his hand with foreign object penetration. A couple of stitches are nothing that you, a seasoned mini surgeon, can't handle, and the patient, who just a few minutes earlier had a glass shard embedded deep in his hand, is sent home with a smile on his face (Thanks M. for your help and supervision). I came out of that room and thought: "ok how bad can the next one be?"

Right then, or a few minutes later, comes exactly what is needed to beat your newly found feeling of empowerment back into submission, and your newly found heightened sense of self right back into the ground. About 30-40 minutes after that minor surgery, there came the patient who had arrested at home and was brought in by the Lebanese Red Cross. Somewhere amidst all the hype that surrounds such cases, A couple other med students and I were standing around, feeling lost. You feel lost and completely helpless, especially when you see the ER attending in action. Shouting out tens of orders by the second, telling the nurse to give drugs that by the time you remember their generic names or what they do, are already given and second doses pending. There's nothing better than that feeling to bring you back down to earth from that trip you took earlier because you put bandaid on a wound. A man is dying right there on the stretcher, and you can do absolutely nothing about it.

I've felt helpless before. But feeling helpless over a life that's expiring is just something different. You go home, with the image of the patient's blue, expressionless, and nonreactive face as you saw it, staring down at it while performing CPR as best you could. There was no hope anyway.

Then you try to look at the positives. My colleagues and I helped give that patient a few extra heartbeats, artificial ones, but heartbeats nonetheless...