Echoes From the Hallway

Just sometimes, the practice of medicine becomes onerous. Just sometimes the pulmonary embolisms are too stifling, the myocardial infarctions too pressurizing and those hip fractures too achy. With one case following the other, one’s empathy and compassion get buried beneath the units of blood, chest compressions, epinephrine boluses, endotracheal tubes and measured urine outputs. 
After hours of patient care, one reaches a point where thoughts of the warm couch and a cold one are so intrusive that, they threaten to sweep away the right doses one has memorized for starting a patient on Amiodarone.
Sometimes, the practice wears on the body and the soul.

Recently, I had such a day. Finally, after some 13 or so hours, I scurried off to the locker room to change and head home. I was so relieved to be able to finally leave it all behind. Or so I thought. 
I changed faster than a Broadway artiste and headed for the door. 
Now, the locker room has two main doors. One leads into the operating rooms suite while the other leads to a long hallway that is flanked by a ward, two intensive care units and waiting rooms for family members. The hallway also leads to a stairwell that leads to a door that lets one out of the hospital.


As I neared the into-the-hallway-leading locker room door, I heard a curious sound coming from the hallway. For a minute I thought someone was crying but the walls muffled the sound. I opened the door and made the left turn into the hallway and was immediately greeted by a most heartbreaking sight.
In the hallway were maybe 20 people who seemed to be related and they were all crying really uncontrollably.

It is not uncommon to see the family members of patients in either intensive care units hanging around in the hallway instead of staying in the waiting rooms. The reasons they do that are myriad. The most common is that the waiting rooms are full. Another is that a patient was just admitted, so the family members are still finding their bearings. Other times, the patient might not be doing well and the loved ones are all trying to see him or her before it is too late. Then, there is also the instance where a family member dies in one of the units. 
As I stopped momentarily, frozen by the display of grief around me, I knew this was one of those instances where a patient had died and the family members were grieving openly in the hallway. It was not the first time I had seen patient family members crying in that hallway but never had I witnessed that number of weeping and heartbroken visitors.
For a minute I thought of using another route to the parking garage but something made we walk down that hallway between all those sobbing people and a chaplain, trying unsuccessfully to console them. The sobs bore into my very soul and their tears seemed to just flow. For what seemed like an eternity, I walked down that hallway, legs and heart quite heavy.
Finally, I turned the corner, went down the stairs and out of the hospital. 

Just sometimes, the practice of medicine becomes onerous. Just sometimes the pulmonary embolisms are too stifling, the myocardial infarctions too pressurizing and those hip fractures too achy. With one case following the other, one’s empathy and compassion get buried beneath the units of blood, chest compressions, epinephrine boluses, endotracheal tubes and measured urine outputs. 
After hours of patient care, one reaches a point where thoughts of the warm couch and a cold one are so intrusive that, they threaten to sweep away the right doses one has memorized for starting a patient on Amiodarone.
Sometimes, the practice wears on the body and the soul.

I walked briskly to my car, opened it and sat down. I noticed I was breathing rather fast. I tried to catch my breath and thoughts. Suddenly, my tiredness felt so secondary. Suddenly, the long day felt so unimportant and the warmth of my couch was not such a pressing need.
The empathy came flooding back. The compassion rolled over me.

I had seen grief and sensed loss and they made life so much more important. They put what I did, what we do within those walls in perspective. They humanized the pulmonary emboli, the strokes, the dissections, the fractures. I sat in the car and realized that I could not let my empathy and compassion be buried under units of blood, chest compressions, epinephrine boluses, endotracheal tubes, and measured urine outputs. That I had to reach in there and fish them out as soon as I realized they were drowning in the busy-ness of the day. Then behind those people we call patients, behind those people who make us work really hard and miss out on warm couches and beds are the lives they have left behind and hope to return to. Lives that include people who love them and will cry uncontrollably in a cold hallway if these patients do not make it.

I started the car, reversed and drove off. The radio came on and an old Stevie Wonder song was playing but even that could not keep the echoes away – the echoes of those visitors crying in the hallway. Death really has a way of reminding us about life and a special style of putting it all in perspective.