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Abstract
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I’m not one for written reflection. I certainly don’t keep a journal. But I made a point to write down the date—July 28, 2018. This was the first day that I saw a patient, victimized by insensible violence, die in front of me.
At the time, I was a surgical intern. My job on the trauma service was to complete the primary survey. The role of the primary surveyor is to perform a rapid head-to-toe assessment of the trauma patient and report critical findings to the team leader. It’s a job that nearly every surgical intern in the country is familiar with. On July 28, the emergency department took report that a motorcyclist was coming in after sustaining a gunshot wound (GSW) to his right arm. When the patient arrived to the bay, it became clear that the report and the reality of the situation did not align. I could see that he had been shot in the head; his extremities were uninvolved. The patient was an approximately 40-year-old African American male who was still wearing his helmet and leather jacket, which was engraved with letters from his motorcycle club.
I immediately felt his neck for a carotid pulse and there was none. The next moment is the one that has stuck with me. I cut the chin strap and removed his helmet and there was gray matter from his brain oozing out to the side of the bed. His pupils were blown. His time was over. That particular night we didn’t even observe a moment of silence. I didn’t talk to anyone about what we had had witnessed. We kept it moving because we had to. We had other patients to attend to, other families to break bad news to. I got a brief report from one of the officers on scene who stated that someone rolled up beside the guy at a stop light and shot him in cold blood. The police unfortunately had no leads. Maybe he was in the wrong place at the wrong time, or maybe he had it coming?
That event in isolation was enough for me, as it would be for most people. I had a couple of dreams about the event in the first few months after it happened; I have always been able to recall the face of that patient in my mind’s eye. Since that time, there have been other similar situations. In fact, I have cared for two to three hundred victims of gun violence since starting residency. Some encounters have been more serious than others. I’ve operated on many of these patients. Many of them have died. I’ve always rationalized that emotional toughness is part of the job. Surgeons need to compartmentalize their emotions so they can be effective. Plus, I have grit. I’m in the Army. I was raised not to be soft. I’m fit for this ...
Language: en |