2020: In Brief

“Be willing to be surprised; be open to the unexpected”.

Wow. To say we had no idea what was coming our way approximately 365 days ago is an understatement. I always like to sit down and reflect a bit before the New Year because it’s a nice transition point to pause, re-evaluate, and reflect. Last year, I wrote myself a motto – “Be willing to be surprised; be open to the unexpected”.

Obviously, the pandemic was the biggest shock. Bringing with it grief, despair, death, sickness, loneliness, poverty. I understand how catching COVID could seem like small potatoes compared to losing your job, missing family, concerts, travel. Many people experience no symptoms, or very mild symptoms. But have you ever witnessed someone getting chest compressions? It’s not delicate. Bones break as you must push hard enough to pump someone’s stopped heart from the outside. When someone “codes” it seems like the entire hospital gathers outside the room. To offer assistance to the providers working hard to bring the patient back to life. Literally.

At the beginning of December, a call from my medical school came out to 4th year students like myself to help. The COVID units were overflowing with patients and the hospitals were preparing for the holiday surge of cases. After many months of pushing hospital providers to their limits they needed help.

Let me tell you, it was scary.

I feel incredibly grateful for how sheltered I’ve been from COVID. Since I’m going into General Surgery, all the patient’s I’ve worked with over the last few months have to test negative before coming to surgery. In the trauma ICU, we were considered the COVID-free ICU. December was my first time coming face-to-face with the sickest of COVID patients. I called families to update them on their loved one’s health and our plans for the day since they couldn’t come to visit. I checked labs and monitored kidney function. I did whatever I could so that the providers could go home when their shift ended instead of hours after.

Thankfully, our hospital numbers have gone down, but there are many places where cases are still spiking, and while we can certainly make space to put patients, who is going to take care of them? There are only so many nurses, respiratory therapists, nurse assistants, doctors, housekeeping staff.

It’s exhausting always feeling like we have to weigh the risks of our decisions. But we need to keep doing just that.

I got the first dose of the vaccine (will get the second soon), but I will continue to check in with my choices before I walk out the door. To protect my family, my friends, my loved ones, and then ultimately to protect you because we are all connected.

As I’m sure you can relate, I’m hoping for a little less of the unexpected this coming year. More certainty sounds nice. But, if life has taught me anything it’s that uncertainty is for certain. So, while I pray for some peace and certainty, I’ll keep on trying my best to live in the moments and love the people who come my way.

This will be my motto for 2021: “Ask more questions than I answer – seek to understand”.

Not My Patagonia

I slowed my pace as I walked from the Emergency Department CT scanner back to my computer in Care Unit 1. My shoes briefly disturbed the down that had settled on the floor. Gravity pulled it back to the ground. 

As I passed the recess bay, my eyes turned to where more feathers rested amidst the gloves discarded in haste and drops of blood left behind on the sanitized stage. He was in the hands of the trauma surgeons now with act two listed as a pelvic artery embolization, followed by an appearance in the operating theater. For a moment, the emergency department had returned to calm as the actors dispersed at the end of a rehearsed performance.

He came to us for help after he was struck by a car. The charge nurse told the room as we prepared for his arrival by ambulance, “pedestrian versus motor vehicle”. My preceptor would later draw an image on a sticky note for me; pictured was a car and stick figure as they made contact. One of our learning points for the day would be the classic pattern of injuries seen in these types of situations.

Who was he, our main character? John Doe, a man who happened to be wearing a blue Patagonia jacket when he became the victim of an unfortunate accident. The EMS team wheeled him in and the room sprang to action; a dance unfolded before my eyes. We methodically assessed his airway, breathing and circulation. “Do we have a blood pressure yet?” 80/40. “Let’s get some fluids running.” He shouted in pain when we pressed on his pelvis. We wrapped him in a pelvic binder. Abdominal ultrasound didn’t show any free fluid, but that didn’t mean it wasn’t there. We rushed to the scanner in search of more information. There was a blush down in his pelvis on CT, a sure sign of ongoing bleeding and an explanation for his soft pressures.

It was almost a comical scene as I recalled the feathers marking his path through the hospital, the lead trauma surgeon failing to remove them from his pant leg while we waited for the scans, the suppressed laughter from the staff watching these repeated attempts, the EMT apologizing for creating this mess.

But, what was this mess? Would John have made a different decision on his choice of outerwear had he known that he would later be center stage?

In the wake of John’s appearance in the ED, we lamented the inconvenience of the feathers and commented on how we would continue to find them in various corners of the department for weeks to come. My preceptor and I discussed the sticky note. I wondered how he was doing in the next act. In the midst of this tragedy, I wondered if John would be upset upon finding his down jacket ruined and scattered across the hospital halls? Would he find some humor from the way he entered from stage right? Or would it not matter that his coat was destroyed in the effort to save his life?

It wasn’t my Patagonia, but it’s caused me to pause all the same.

Since that morning in the ED, I’ve had the chance to visit and learn more about who John is. When I told him about the jacket, a knowing smile erupted on his face and his eyes pointed to the cupboard in his hospital room – “It’s in there”.