Unknown to the general public, the ED comes in many flavors (1). There is of course the standard emergency room but to help with triage and whatnot there is usually a pediatric and sometimes a geriatric ED in most hospitals. Furthermore, most hospitals also have a "crisis" ED which deals with people who come in with acute psychiatric illnesses (2). This includes acute psychotic breakdowns, exacerbation's of existing mental illnesses, and even really really drunk people who start flailing around at cops with their penis' (3). The crisis ED is also home to some of the most depressing cases in the hospital because unfortunately this is where the people who attempted suicide go (4).
It was my second day working in the crisis ED and I really thought that I had a hang of everything that went on there. I knew how to talk to the depressed people, knew what to do with the really angry people, and even sang along with the super drunk people if it got them to calm down and cooperate (5).
Then Clarice came through the doors.
Clarice had a very flat affect (5) and looked like she had been crying for years but had recently decided to stop. Since my attending was busy working on discharging a patient, I was given the assignment of talking to Clarice and figuring out what happened. The EMS crew that brought her told me that Clarice had been found by her mother after she drank a couple swigs of Drano. They didn't know much beyond that.
Fuck.
I had never dealt with an attempted suicide before and I didn't really know how to begin (7). In my nervousness I must have stood silent as a rock in front of Clarice for an eternity before I even uttered hello. After hearing my voice Clarice simply turned her head at me and gave me the loneliest stare I had ever received in my life and then went back to staring at the wall. I tried for a solid half an hour to talk to her but she wasn't having any of it so I decided to go get some help from my attending.
"Everybody's left me...aint nobody here for me no more."
I stopped dead in my tracks. It had been barely audible but she had broken the sound barrier(8) and it meant that she was ready to talk. Over the next hour or so, Clarice told me her story and pretty much for the entire hour I stood there with my jaw dropping lower and lower to the ground.
Clarice had been a mother of three: Tim and Sean, twin boys - 13 years old each, and Rianna, her 7 year old daughter. She had loved her children with all her heart and had tried to raise them as best as she could. They received good grades in school and never got into any fights. She felt that she was one of the most blessed women in the world.
Three months ago, she had been walking home from a parent teacher meeting with the twins when she noticed that Tim had fallen a little bit behind while crossing the street. She laughed at him to hurry up and that is when the car came out of nowhere and struck her baby boy. They raced him to the hospital but he was pronounced dead on arrival.
The driver had been drunk.
Clarice quickly fell into despair and depression followed shortly after. Two days before she attempted suicide, child protective services had to take Sean and Rianna from her because she had become unable to look after herself, much less her children. She moved in with her parents to get better and thankfully that is how her mother was able to get to her before she drank enough Drano to kill herself.
After hearing her story, I was in tears. It was the most heartbreaking story I had ever heard and to hear it from the grief-trodden mother herself was something that will never leave me.
We were eventually able to help Clarice by helping her realize that her remaining children needed her; this fueled her recovery far more than our interventions. She was discharged three weeks later from the inpatient psychiatry ward to an outpatient facility where she overcame her depression and was reunited with her children four months later.
To say that her story changed me is an understatement. But what I hope to accomplish by telling you her story is to prevent you from even THINKING about drinking and driving. When you have a drink and choose to get behind the wheel, you are agreeing to ruin not only your life or the person that you hit but also EVERYBODY who is attached to both you and that victim. Think about it, not only was Tim killed, but his brother and sister were almost put into the adoption system and his mother almost committed suicide.
Dwell on that next time you think its worth it.
______________________________________________________
1. Obviously I'm talking about the emergency department, I have NO idea what YOU might have thought upon reading "ED" and "many flavors." Pervert.
2. A lot of hospitals don't have a dedicated section for the crisis ED, sometimes its just an area in the hallway that's partitioned off by standing curtains. Happens.
3. Yes that happened. Had to restrain the guy and everything.
4. Clarification, this is where people who attempted suicide but didn't really hurt themselves too badly go. The people who REALLY get hurt go straight to the regular ED on the way to the OR. While that is pretty sad, the cases that end up in the crisis ED are sadder because here you get to talk to the patients while they are still really really depressed and you get an idea of what drove them to it.
5. I have the voice of an angel, numerous drunk people in the NYC area will verify this claim.
6. An affect is your mood as other people perceive it, flat means that its very subdued.
7. Sometimes even really verbose people forget how to talk and this was definitely one of them.
8. A little observation I learned when I was a car salesman: When one person who had previously refused to say a single word finally chooses to do so, it means that they are ready to talk...a lot.
Life, Medical School, and whether the two can actually coexist
Monday, January 23, 2012
Saturday, January 14, 2012
The one with the band of brothers
Here's a secret for all of you guys(1) out there, medical school is frickin hard. Not just regular old "this exam is gonna be hard, why the hell do they make us learn this useless shit any way" kind of hard, its more of a "holy shit if I fail this exam I'm screwed because the rest of my life depends on this(2)" kind of hard. Imagine going through that, every three weeks, for three and a half years(3). That is enough to drive anybody crazy, full on cuckoo bananas crazy.
But here's the thing, you don't really meet too many batshit crazy doctors. Why is that? I mean all the signs say that a hefty chunk of medschool grads should be a little bit unsettled, that is what 3.5 years of constant stress should do to you. But they don't. Most of us make it through the process as sane as the day we started(4), and I don't mind sharing how.
Is your interest piqued?
Ok fine, here it goes: its because of our friends.(5)
In her book, Dr. Michelle Au compared going to medical school to being in the army(6). It isn't really a far fetched comparison when you think about it because both endeavors are harsh and require a hefty amount of teamwork to pull you through it. By the end of both you are a member of a tight band of brothers that have gone to hell and back and know each others deepest secrets. These are the ones that made you relax when you were panicking about the first anatomy exam and the same ones who slapped you back to your senses when you thought that the Step 1 was unbeatable.(7)
However, before I get in too deep with the discussion I think it is wise to point out that not all people go through the same experience. In terms of social willingness, there are two types of people in medical school: the visible and the invisible. The invisible people are those that you never really see in the social realm. For numerous reasons(8), they don't interact too heavily with the other members of their year and pretty much the only time you see them is during school related activities. No joke, during the first two years of school I got used to seeing new faces I had never seen before on exam day. Don't expect these guys to come out to party with you. They still make it through the process just fine.
I'm part of the other group of people, the visible ones. Most of the strong relationships I have right now were formed in medical school(9) and I'm very thankful for that. These friendships started in the anatomy lab when we helped each other figure out which nerve was which, continued in the study lounges and libraries where we couldn't understand the formulas for lung capacities, and were cemented the days before and after exams when we tried to erase our panicking minds with comforting thoughts. After going through such "hardship"(10) it is only reasonable to hang out and party with the people that helped you get through it.
And so we started going out after big exams which led to going out after no exams and pretty soon the people I thought to call on a lazy day weren't the best friends I had growing up, they were the best friends that I grew up with in the study of medicine.
And its safe to say that my experience wasn't alone. The same process that I went through happened with roughly 100 or so other classmates of mine who now have the same bond that I share with my circle. I've grown accustomed to hearing somebody's voice in the hall and knowing exactly who they will be with, it is awesome.
Of course this is nothing new to society. In fact situations such as this are the basis of friendship in every culture. Yet for those of us in medicine, we know that there is nothing quite like the bonds formed through this trial. Friendships formed during high periods of stress are somewhat different that friendships formed during ease. They're like diamonds in that they are formed in relatively short periods of times due to enormous pressure, but ultimately lasting longer than most others.
I'll wrap up this rambling post now(11), but one final statement before I do: to all my friends reading this, thank you so much for being there for me. Without all of you I never would have gotten this far and while there is still much work to be done, I know I can count on you to help me through it. This one is for you my band of brothers.
__________________________________________________________________
1.) And girls, just in case any of you got offended by the male only definition. However I do hate doing the multiple gender PC statements so from here on out just assume that whenever I say "guys" or something of the like I mean "guys and girls."
2.) Another thing you should know, medical students are really dramatic.
3.) The second half of fourth year is pretty much bullshit...we'll get to that later.
4.) Mostly sane...or 3/4 sane at worst!
5.) Bet you didn't see that coming!! Its like the bus that hit Regina George, you know which Regina I'm talking about.
6.) What, you didn't think I was the only one out there writing about this experience did you? Go ahead, search for other blogs...after reading this post.
7.) True story, that exam destroyed my soul.
8.) From my experience, its usually firm grounded relationships that they had prior to school. This ranges from anything between super strong home friends, significant others, kids, etc. You have to remember that a hefty chunk of people in the schooling process are older, they tend to already have lives of their own and don't really need to make too many new friends.
9.) Thats not to say that I have no friends outside of my classmates, far from it. Its just that when you're in school, and single, its really hard to find time to hang out with your other friends. Whenever they're free, you have an exam to study for and whenever you're free, they're working. This is why most of us have such strong friends from medical school, simply because they were around and more or less on the same schedule.
10.) In quotes because lets face it, having to study really hard isn't really a hardship as viewed by the rest of the world. That being said, shit's still hard.
11.) See what I did there? Zing!
But here's the thing, you don't really meet too many batshit crazy doctors. Why is that? I mean all the signs say that a hefty chunk of medschool grads should be a little bit unsettled, that is what 3.5 years of constant stress should do to you. But they don't. Most of us make it through the process as sane as the day we started(4), and I don't mind sharing how.
Is your interest piqued?
Ok fine, here it goes: its because of our friends.(5)
In her book, Dr. Michelle Au compared going to medical school to being in the army(6). It isn't really a far fetched comparison when you think about it because both endeavors are harsh and require a hefty amount of teamwork to pull you through it. By the end of both you are a member of a tight band of brothers that have gone to hell and back and know each others deepest secrets. These are the ones that made you relax when you were panicking about the first anatomy exam and the same ones who slapped you back to your senses when you thought that the Step 1 was unbeatable.(7)
However, before I get in too deep with the discussion I think it is wise to point out that not all people go through the same experience. In terms of social willingness, there are two types of people in medical school: the visible and the invisible. The invisible people are those that you never really see in the social realm. For numerous reasons(8), they don't interact too heavily with the other members of their year and pretty much the only time you see them is during school related activities. No joke, during the first two years of school I got used to seeing new faces I had never seen before on exam day. Don't expect these guys to come out to party with you. They still make it through the process just fine.
I'm part of the other group of people, the visible ones. Most of the strong relationships I have right now were formed in medical school(9) and I'm very thankful for that. These friendships started in the anatomy lab when we helped each other figure out which nerve was which, continued in the study lounges and libraries where we couldn't understand the formulas for lung capacities, and were cemented the days before and after exams when we tried to erase our panicking minds with comforting thoughts. After going through such "hardship"(10) it is only reasonable to hang out and party with the people that helped you get through it.
And so we started going out after big exams which led to going out after no exams and pretty soon the people I thought to call on a lazy day weren't the best friends I had growing up, they were the best friends that I grew up with in the study of medicine.
And its safe to say that my experience wasn't alone. The same process that I went through happened with roughly 100 or so other classmates of mine who now have the same bond that I share with my circle. I've grown accustomed to hearing somebody's voice in the hall and knowing exactly who they will be with, it is awesome.
Of course this is nothing new to society. In fact situations such as this are the basis of friendship in every culture. Yet for those of us in medicine, we know that there is nothing quite like the bonds formed through this trial. Friendships formed during high periods of stress are somewhat different that friendships formed during ease. They're like diamonds in that they are formed in relatively short periods of times due to enormous pressure, but ultimately lasting longer than most others.
I'll wrap up this rambling post now(11), but one final statement before I do: to all my friends reading this, thank you so much for being there for me. Without all of you I never would have gotten this far and while there is still much work to be done, I know I can count on you to help me through it. This one is for you my band of brothers.
__________________________________________________________________
1.) And girls, just in case any of you got offended by the male only definition. However I do hate doing the multiple gender PC statements so from here on out just assume that whenever I say "guys" or something of the like I mean "guys and girls."
2.) Another thing you should know, medical students are really dramatic.
3.) The second half of fourth year is pretty much bullshit...we'll get to that later.
4.) Mostly sane...or 3/4 sane at worst!
5.) Bet you didn't see that coming!! Its like the bus that hit Regina George, you know which Regina I'm talking about.
6.) What, you didn't think I was the only one out there writing about this experience did you? Go ahead, search for other blogs...after reading this post.
7.) True story, that exam destroyed my soul.
8.) From my experience, its usually firm grounded relationships that they had prior to school. This ranges from anything between super strong home friends, significant others, kids, etc. You have to remember that a hefty chunk of people in the schooling process are older, they tend to already have lives of their own and don't really need to make too many new friends.
9.) Thats not to say that I have no friends outside of my classmates, far from it. Its just that when you're in school, and single, its really hard to find time to hang out with your other friends. Whenever they're free, you have an exam to study for and whenever you're free, they're working. This is why most of us have such strong friends from medical school, simply because they were around and more or less on the same schedule.
10.) In quotes because lets face it, having to study really hard isn't really a hardship as viewed by the rest of the world. That being said, shit's still hard.
11.) See what I did there? Zing!
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