Mortality

You always see the doctors on TV saying "We did everything we could...but..." and it seems so easy.

We told a family that same thing last week, and it was the hardest thing to be a part of. I was on trauma call when Mr. X came in. He'd been hit by a car as he was crossing the street on his way to the grocery store. He came in a little hypotensive, so we pumped fluids into him and tried to get X-rays and the FAST scan to see what was going on inside of him. We assumed that the major injury was his open head wound. Things were going well...he was still hypotensive, but hanging in there...and then all of a sudden he bottomed out. COMPLETELY bottomed. BP was not palpable, pulses were not palpable, you name it. We activated ACLS protocol and got to work. I have never worked so hard or had my arms hurt as much as they did while doing those chest compressions. After about 10-15 minutes, we gave up and called it. We stripped off our gowns, threw our gloves away, and called it quits. And then...from the monitors...the faintest "blip...blip blip...blip" sounded. He was back in the game, and so we were.

The story could drag on, but the bottom line was that the guy coded twice more,once on the CT scan table and once in the OR before cardio even had a chance to crack his chest. We lost him.

It's hard for me on different levels to accept this. It's hard because I'm a perfectionist. I'm used to things working out. I'm used to trying my hardest and getting results. It's hard because I feel like I let myself down. It's hard when your best simply isn't good enough.

It's hard because I went into medicine to be a positive change in the world - to save the lost, heal the sick, piece together the broken. It's hard to come to terms with the fact that you can't save everyone. Knowing that you can't save everyone and having that fact shoved in your face are two separate things.

It's hard for me because I forget that life really is just a few precious moments on this round piece of real estate. When they are gone, nothing can bring them back. It's hard to be reminded of something so simple: that we all die. And truthfully, I am finding that remembering the inherent mortality of a human being is very hard.

Lessons

As much as I enjoy learning...

As much as I enjoy the challenges of medicine...

As much as I love medicine (good days and bad)...

I'm realizing that there are depths to human beings that I will never understand and situations that will drain me in every way a person can be drained.

I'm learning that sometimes what I see day-to-day has the power to break my heart into a million pieces.

Today was one of those days. I can't go into details because the case I was in on has gotten some news time and you can never be entirely sure who reads your blog. All I can say is that it's amazing to me how medicine can blow your mind and break your heart at the same time.

To be quite frank, I'm worried that one day something I see will break my heart so completely that there are no pieces left to put back together.

What then?