Reflections on being “Inside the Emergency” from my book, CARE 101
Frank Gabrin, DO
I was working in an inner-city hospital while an unfortunate young man was walking down the street outside the hospital when he was hit in the neck by a stray bullet. I remember walking alongside his gurney as they rolled him into the big bay at the front of the department. He looked terrified, wondering if he was going to live. I immediately got his attention, telling him that I was his doctor and that I was going to take great care of him, that he was not going to die but things were about to happen very quickly and I needed his full, undivided attention and complete cooperation.
A look of relief washed across his face as he nodded that he understood. I asked him his name and demographic information as the staff got him registered and into the computer system. There was no chart or computer for me to deal with in this moment of crisis. Although there were many team members with me in the room, starting IVs, drawing blood, hooking him up to the monitor, shoving XR plates behind his back, cutting his clothes from his body, placing bandages over the bullet hole in the front left side of his neck and looking for the exit wound that could not be found, it seemed as if it was only the two of us, my patient and me. Our attention was firmly focused on each other. We were most definitely connected.
As I quickly performed the history and physical exam, I told him that I was worried about the swelling happening in his neck and that he would lose his airway. I told him that I was going to have to put a breathing tube through his mouth into his lungs and that I would have to take his consciousness away from him so that he would not feel any of this.
I asked him who we should call to come and be with him. I told him that when he woke up, he would be at a different hospital and I would not be there, but to trust the doctors and nurses who would in the room with him when he woke up. I let him know that he most probably would be going into surgery to repair the damage done by the gunshot. I could see in his eyes that he knew I understood what he was going through in that moment, and knew I was acting out of intense compassion for him. He could most definitely feel my care.
Thankfully, he did well and the bullet did not strike any important structures in his neck. He went on to enjoy the same quality of life, at least physically, that he’d enjoyed before the unexpected and unthinkable trauma occurred. I loved this experience, and I remember it, because I knew that by connecting with him, I had made a difference.
The other thing I loved about the experience was how, even though I was not focused on my team, my team was focused on me while I focused on my patient. They anticipated my every need. They executed flawless teamwork as they notified the nearby trauma center and the helicopter service, called his family, got the two units of blood up and helped with the intubation and the conscious sedation.
They were connected to him through me: everyone, even the secretary at the desk making the calls, was feeling empathy and compassion for this poor guy. Everyone knew his or her place on the team. Everyone performed his or her duties flawlessly. Everyone was totally engaged with this case and everyone felt incredibly good as a result of his or her efforts in this case. When they talked to each other about it, smiles filled the room. This is what happens in a real emergency; this is the very best of Emergency Medicine.
Do you have an experience to share which demonstrates how you feel when you are connected to your altruistic purpose and your patient? What allows you to block those antigens/obstacles which may be limiting your strengths? What gives you the ability to truly be there for yourself and others during times of being “in the moment,” “being in the flow,” or “being connected to your true healing spirit.”
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