I am currently 40 years old. I have been in the medical field in various capacities for over 15 years. In my time I have assisted on over 100 bone marrow biopsies, at least two dozen lumbar punctures, sat with my Oncology patients as they receive their chemo, sat by their bedside as they take their final breaths. I have worked in a level III trauma unit where I have watched doctors place chest tubes, assess hikers who were airlifted to our hospital from the surrounding mountains, draw labs from a femoral vein when no other veins could be accessed. I was there when a man was brought in hypothermic. He was warmed and when he woke up, he was very disoriented and combative. I have worked in psychiatric units where patients are not lucid, bound with soft restraints. I have assisted on more codes than I can count. I have drawn blood from clinically dead patients. I have been there when the doctor has pronounced their death.
Emergency medicine is not for everyone. You have to be calm under pressure. You are dealing with life and death situations. Families of the patients. There can be language barriers and high emotions. You must be able to work fast and know what needs to be done and delegate tasks. You have to be fine with all manner of body fluids. You will see the human body in ways you never thought possible. You have to be able to see it, assess it, and fix it. Without showing fear or disgust. These are still people, still deserving of their dignity.
When you consider studying medicine you may not realize how much you will need to compartmentalize your work and your life. You need to be able to find good after the bad. Treat everyone with respect even when they aren’t respecting you. You need to analyze your true feelings on bodies and their functions. You will get all of them on you at some point. You cannot be afraid to look at genitals and anuses. Those are often exposed during emergencies or even the origin of the emergency. You will see people at their worst but need to not show any reaction. Most people are not the cause of their emergency so they are often embarrassed and may not tell the whole story due to that. Your job is not to judge, it is to help.
If you notice your mental health taking a hit during your schooling or internship, seek support. There is no shame in talking to someone about the things you see. Trauma accidents can be very gory and those images can be hard to forget. It can be very unnerving to assist on pediatric patients. Especially if you are a parent. Talking about those scenes really helps relieve your mind. Don’t bottle it up, that never ends well. Try to talk to your parents or partner about the stressors of the job so they can try to understand any mood changes and identify if you are heading toward depression or an anxiety disorder. You cannot be an effective care provider if you are not healthy yourself.
At the end of the day you are doing the work you are trained to do. You will not always succeed. But when you do, the reward is what keeps you going. When you save someone’s life there are so many people affected by that. Over time you may not recall all of them but they will never forget you. That being said, make a positive impact. Treat them like they are your own family. That person lying there is someone’s child, parent, sibling, partner. Give them the best care possible, treat them with dignity and respect, and be humble.
You are not alone in this work either. There are full support staff too. Remember that no matter what their job title is, they are on your team. Treat them as equals, be kind, teach those who want to learn. Ask questions, you can always learn something. Take each day as it comes. They are not all the same.
Another very important part of medicine is listening. Patients know their bodies. They may not have the lingo down or say things succinctly but they know how they feel. Don’t get caught up in being right, take time to really listen and consider what the patient is asking. Some will say they read an article and want specific tests run. You may not think they are remotely close to being correct but what’s the harm in ordering the tests? The patient needs to trust that their provider has their best interests in mind. Be careful to not rush to a conclusion and push that as fact until you have evidence. And when you are presenting evidence remember that denial is very powerful. You will have patients that flat out refuse to believe you. Gently suggest they seek a second opinion. It will be their choice from there. Not every patient will listen to their provider-they will avoid Physical Therapy, medication therapy, and even go so far as to prove you wrong. Try to have empathy when that happens, we don’t always know the full picture of their lives and they may be reacting poorly for reasons they haven’t shared.