By Alyssa Brown
How was your day?
This is always such a loaded question. It also probably explains why I don’t call my family and non-medical friends as much while I’m on the trauma ICU rotation. I want to tell them everything I saw that day, but I also don’t. I know they probably don’t want to hear it—the gruesome details of: unhelmeted motorcycle accidents, stabbings, shootings, and car accidents. The patient list keeps stacking up as we move through the 24 hour shift, and the pager keeps ringing. As a patient is discharged from the ICU, another gets admitted and takes their place. They ask me how my call was – I usually reply “busy” and keep it at that. They don’t need to know I watched a septic patient code twice, a gunshot victim come in dead on arrival, or about the knife wound that wouldn’t stop bleeding. They don’t need to know that I’ve changed my scrubs twice because of blood splatter or that I have eaten mostly Zesta crackers and peanut butter for the last 24 hours. They ask if I got any sleep, and I reply “some”. I think dozing off for a few minutes in the workroom counts. These are details that are best left to the people inside this world. To the outside world, I am just coming and going from the hospital. The details to them remain a vague mystery.
On the first day, I mentioned to my parents what we had done. A burn patient needed a central line and a motor vehicle accident patient needed to have his abdominal wound closed. They shuddered. They clearly did not want any details. They didn’t want to hear about it. I guess it makes sense. How many people realistically want to listen to the stories of death and destruction? They wanted their daughter to be a doctor. They didn’t and probably don’t quite grasp what I am seeing every day in the trauma ICU. With people in medicine, we share everything in gory detail. We share war stories of terrible cases. It is a little macabre. We all have our stories. I think it is just our emotional processing of this daily and repeated trauma in front of us.
In the darkness though, there were moments of light. There were some people who got better. There were many small miracles too: a patient waking up to talk to their family before later passing, patients being surrounded by so many family members and friends, family’s deciding to donate the organs of their loved ones. Also, sometimes, we just had to laugh at the unexpected. We laughed with our patients and together with the team sometimes. One day, I couldn’t find the team, until I peered into the breakroom and found them snacking on some sherbert pilfered from the fridge. The attending called it sherbert rounds, and he stated we needed something good to start the day. We laughed until we cried the day that we ordered Thai food, and when it didn’t show up, we realized we had ordered it from New Mexico rather than Kentucky. Some days these laughs and small miracles were how we survived.
There is a code in medicine that what we do stays within the bounds of the hospital and the people that work there. It is so hard to explain “how was your day?” I don’t usually have a good answer to outsiders, and I don’t want to be too honest. I do wish they could stand at the window some days and see the care and compassion of the people inside. I wish they sometimes understood a little better how the day had been. Maybe it is a balance between letting friends and family see a small window in, but not revealing too much of the full picture. Either way, I know the small miracles, big miracles, and laughs are sometimes what sustains us through the darkest times.
Alyssa Brown grew up in Chattanooga, TN. She went to Centre College for a B.S. in Biology and minor in History. She fell in love with surgery after seeing her mentor perform an anoplasty during the first year of medical school. She finished her third year of medical school in 2018 and wandered off the beaten path to get a PhD, before finishing her MD. She is receiving her MD degree from the University of Louisville School of Medicine, and her PhD in Biomedical Engineering and Physiology at Mayo Clinic School of Biomedical Sciences. She just started her fourth year back at Louisville (clearly). Her thesis research is on diaphragm muscle mitochondrial function and morphology. She also participates in research projects focused on physician infertility, student mental health, and pediatric surgery. She has been a part of the AWS Blog Subcommittee and AWS Instagram Subcommittee for three years, and she has loved writing pieces for the blog over the past two years. During the pandemic, you will probably find her baking sweets and pastries that she saw on “Great British Bake-Off,” or embroidering. You can find her on Instagram @Alyssa_b_futuremdphd and on Twitter @Alyssa_B_MDPhD.
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