They should have warned us

 

They don’t warn you.

They just sort of throw you in and give you a thumbs up.

Swim.

Actually, that’s not true. There is no thumbs up. There is only a stern look and a finger pointer at a code of ethics.

“We’re watching you.” they say. Then they throw you in.

Swim.

I’m not talking about medical school. Yes, most of us went into that blind and foolish, led by castles we had built in the sky. That topic deserves it’s own post.

I’m talking about the actual practice. The real stuff. Doctoring.

Nobody warns you.

Nobody says. “Oh hey. You’re going to see a lot of people die. You’re going to sit in front of people crying their eyes out, experiencing the worst day of their life, but for you it will just be a Monday. A regular Monday.”

They don’t tell you your time is going to shrink. You’re going to miss a lot of important social events. And your friends and family will understand…but not really.

They don’t tell you.

In a way, I understand it. I'm there now; I’m in the deep end, and I feel fine.

I have never cried when a patient passed away. I have felt sad yes, but never tears.

Honestly, sometimes I wonder if there is something wrong with me. Then I realize I’m not the only one. A number of my colleagues are the same. We are all just kind of okay. We have learnt to roll with it.

We have adapted, or maybe we have become calloused. Maybe those 2 things are the same.

I remember one particular case…

A child coded while I was on night duty. She stopped breathing. Her heart stopped beating. She was 5 or 6 years old.

We fought. We fought hard.

I have administered basic and advanced life support many times. I barely remember any. I remember that night.

I remember hearing the child’s ribs crack as I pushed trying to maintain her circulation.

We lost. The resuscitation failed and we had to solemnly break the bad news to the family. I remember their tears.

But what I remember most about that night is what happened 10 minutes after that.

10 minutes after solemnly breaking bad news, my colleagues and I were sitting around a table teasing each other and cracking jokes about anything and everything.

I remember laughing long and hard as we brought up a memory of one person’s unfortunate answer in class.

I remember pausing in the middle of my laughter and thinking. ‘Hey now. Didn’t we just experience something traumatic?’ Then I continued laughing, this time laughing at the whole situation.

Psychologists define defense mechanisms as unconscious resources used by the mind to decrease internal stress.

Defense mechanisms are natural and healthy unless they start to get out of proportion (like pretty much everything in psychology/psychiatry).

Was our laughter that day a defense mechanism? Was I employing Humor? I don’t know.

Is my lack of emotional response to the demise of most patients a defense mechanism? Do I utilize Suppression? Or worse, Repression? I don’t know.

I do 100% believe that a lot of doctors practice sublimation and projection, which are not very healthy defense mechanisms.

Humor and suppression are considered mature defense mechanisms so I guess that’s something to be happy about.

Look out for your doctor friends. Pray for them. Ask them if they are okay. Question their outlandish behavior if you notice it.

They should have warned us…