I had just laid down my exhausted head on the pillow Friday night, after a long shift being on call the previous night, when my cell phone rang. I looked at the number and saw that it was the hospital calling. My finger hesitated over the answer button as I wondered why the hell the hospital was calling me on a Friday night, when I was definitely NOT on call. I decided to pretend that I didn’t see the call coming in, put the phone down, and closed my eyes. 30 seconds later the house phone rang, I swore out loud, jumped out of bed, and answered it. It was a nurse at the hospital telling me the ER doctor needed me to come in.

I slammed the phone down, swore while I was changing out of my PJs and back into my work clothes, fuming on the inside. My daughter texted me at that moment, to which I replied that I had to go back to work, and to make sure that she never ever decided to become a doctor. I went across the street, into the ER, where the doctor on call came up to me and said, “Remember that patient I saw today who got kicked by a cow? Well we have another one, and this one is worse. He’s down in that room over there, go take a look.” I trudged down the hall thinking, great now I’m going to be up all night stitching this guy up…and walked into a room with a guy holding a towel over his face. I dreaded what was under the towel, and when I asked what happened, the patient unveiled himself…..and it was my husband! (and no he was not mauled by a cow). My sweet deer husband had surprised me by driving 6 hours to come and visit me way out in Burns, OR. I beamed as I grabbed his hand, and walked happily out of the hospital.

Thankfully I’ve now had 2 days to recharge and reconnect with Ronando, before I head back into the fray tomorrow. The past weeks have continued to be full of pretty mild and easy patient interactions, interspersed with the occasional traumatic events. The major one of the last week was a multi-victim motor vehicle accident, caused by a mom who feel asleep while driving with her 3 children, a few of which were not in seat belts, and rolled her suburban. Luckily the accident happened many miles outside of town, so the hospital had time to call in backup nurses and all the other health care providers that were available. I swear that all the the medical personnel in the town were in the ER. As we all waited in the ER, and heard the updates from the paramedics who were transporting the 4 patients from the scene, it was decided which doctor and nurses would take care of which patient, who would be the scribe – the person who writes down everything the doctor yells out while examining the patient. I tagged along behind my preceptor while we prepared for their arrival, happy to not have to make any decisions on my own.

We took care of the mom, who, like her three children, were all strapped to a back board, with a cervical collar around her neck. She was pretty hysterical, mainly because she felt responsible for the accident, and because her 5 year old girl was on the table next to her in the trauma bay, and the girl was not happy about being poked with needles to get IV access, or about being strapped down immobile. The girl had been unrestrained in the vehicle, and had therefore been thrown out of the car at some point during the rollover accident. The ER was a mess of people darting back and forth between the four patients, as we had to decide which patient was most critical, and therefore first to get into the CT scanner, and first to have lab work done. It was the little girl who took the first spot, and it turned out she had a fractured skull, and had to be flown via helicopter to Bend, where neurosurgeons would be there to further evaluate. Our patient, the mom, was more stable, although she had hit her head on the windshield (also did not have her seat belt on), and we had to scan her neck, head, and pelvis, before we let her off the back board.

One of her sons was not so lucky, and he also had to be flown to Bend in the same helicopter as his sister, as he had a collapsed lung, and a fractured kidney (didn’t even know that was possible). The other son escaped with minor bruises. All in all, it was a fortunate thing that none of the patients died, given the high speed, the rollover, and some of the patients having not been restrained. I cringed today when I drove by the car shop and saw her crushed suburban, sitting there as a sad reminder that our bodies are just bags of blood and bones, and very vulnerable to injury in car accidents. After all the excitement died down, the patients had been scanned and the nature of the injuries understood, I found myself spending most of the time with the mom, gently trying to clean off the dried blood on her forehead, careful to clean her lacerations and look for any glass. She was still crying, out of fear and guilt, and I had to reassure her over an over that everything would be OK, that her children were alive, and presently stable. I initially tried to contradict her statements about it being her own fault, and then let that go, since there is no way she will ever forgive herself for falling asleep, and for allowing her children to be unbuckled. I had to hold back my own tears, and try not to imagine what it would be like if my own daughter Erinna was the victim.

I held it together long enough to make it back to my house much later that night. I took a shower to try and wash off the drama of the day, and found myself bursting into sobs. All that energy of fear and trauma had just been stored up in my body, and I couldn’t stop it from now escaping. I let myself cry until I couldn’t anymore, and then fell asleep exhausted. I don’t know how ER doctors deal with this kind of trauma day in and day out, but I know for sure that it would eat me up from the inside out. 3 weeks of the occasional trauma out here in Burns is enough for a lifetime for me. I can only hope that my last 2 weeks are slow, boring, and just plain ordinary. We shall see, we shall see. Cheers!

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