While in medical school, I read the book "The House of God." It's the story of an intern and his first year. There's a line in that book about how sometimes patients "can hurt you back."
When my friends and I graduated from medical school and started our
internships, we all had a day where we began to question our decision
about being in our chosen residency. Then as time went on you found
your footing and settled in. Yesterday, I had another of those
"internship" moments.
Somewhere between the patient who came in with multiple bug bites, the transvestite high on crack and meth, the frequent flyer who called 911 from the emergency room when she didn't get a second dose of narcotic medications, the young ATV accident patient who had a seizure after flying over the handlebars, and the patient with a gunshot wound to the arm who had encountered "Three Dudes" I found myself alone running a resuscitation code on a patient.
After we got the heart beating again, the patient proceeded to "code" three more times. When the family arrived we were in the middle of the third code. I had them taken to the quiet room where I was going to go talk to them about stopping the chest compressions. I was in the middle of trying to get them to understand that most likely their family member wasn't going to live when my attending walked in the room, basically asked if a decision had been made about stopping care and to let us know as soon as it was, and then walked out of the room. The family fell apart. What should have been a peaceful discussion turned into a chaos of emotions. I think that's when I had my "what am I doing here" moment and lost it.
There was something in the air yesterday. One of the attendings told me to "go enjoy a cocktail" after the day that I'd had. By the time I finally finished up an hour and a half after my shift should have ended, my senior was leaving too. They told me they were impressed at how I handled the coding patient and family. They were about to step in, but then just thought "you got it, go on with your bad self." And that's why you step back, suck it in, and go on. Like in the book, you can't let the patients get to you.
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