Another day in the Emergency Department

By Meg Jack, MD
Carson Tahoe Emergency Department Medical Director

The alarm clock begins to buzz and startles my eyes open.  My day begins just like any other working person’s day.  I get myself ready thinking of the myriad of things I need to check off of my to-do list. I try not to spill coffee during my commute, but the inevitable slip-up dribble happens and I pray that it lands on the seatbelt instead of my scrubs.

I use my commute to shift from making lunches, securing ponytails, and double-checking that homework assignments are packed in backpacks to emotionally preparing for the uncertain day ahead. As an Emergency Medicine doctor, we must bring the best version of ourselves and we must be prepared for anything the moment we walk into the department. Consequently, I mentally and emotionally compartmentalize leaving the issues going on in my own life in my car so that I can provide 100% of my attention to patients. When we first start emergency medicine training, many get anxiety before shifts because of this uncertainty.

We hope for the days where we have enough time to say hello to the team, but often we arrive and we are immediately being pulled into a room with a patient in respiratory distress who needs to be intubated, a patient with a fatal heart arrhythmia, a coding patient, a threatening patient, or an intoxicated patient who has been to the department countless times. Yet that anxiety goes away in time, and we learn to adjust to the ever-changing environment in which we work.  We learn to pat ourselves on the back because everyone else is busy. We get to see patients at their worst moments, and a ‘thank you’ is few and far between.  We do, however, have moments where we meet fabulous people.  We get to know that we have made a difference or make a connection with someone.

Recently, I walked into the department and the first chart I picked up set a positive tone the entire day. I took care of a gentleman with a minor injury. When I asked how it happened, he and his wife explained that it was a fishing accident. We were jovially conversing about his “fishing accident” and how they wanted to try out fishing, but they didn’t catch anything.  I found it curious when his wife said, “I wanted to go fishing so we did, and it doesn’t matter that we didn’t catch any, because I am finally living.”  When I asked her what she meant by that, she explained that she was prescribed morphine extending 20 years for chronic pain.  When the new opioid laws passed 2 years ago, her doctor stopped writing it for her.  She went through severe withdrawals and ended up in our Emergency Department, and subsequently, Behavioral Health Services.  She said she didn’t smile for two weeks. She said that she didn’t recognize that she lived in such a fog until she came off the morphine.  Realizing that she was often mean to her husband was painful, and the moments she lost to the drug left holes in her heart.

She has since been off all pain medicine, and the hair on her arms has grown back, her skin has brightened up and she has found happiness.  She goes to therapy, uses essential oils and massage for her back rather than medications. Her pain is less than when on the morphine.  Her husband said, “It’s nice to have my wife back.”  He stuck with her during all of this and now they are “living”.  Every Saturday they go on long drives enjoying the beauty of Northern Nevada and appreciate “living”.

It was remarkable to hear this story from a beautiful smile and beaming face. We talked about how positivity breeds positivity and how we are all connected in this world.  I told her how much her story meant to me.  It was such a beautiful conversation, and it was all because of a fishing accident.  It is these moments of connection, knowing we all do make a difference. It fills my soul and helps me to continue doing my job.  These moments are what keep us going.

In the Emergency Department, we tend to hear negative things on a daily basis, and burn out is a nationwide problem.  But there are moments in life when we need to take the time and be present.  Otherwise, we might miss a potential connection, or perhaps the patient might actually be providing the healing. It could be a defining moment to keep us going. I was so thankful to have picked up that chart as my first patient of the day.  I shared this story with all the nurses and other providers and watched them all smile.  The positive start to the day lifted everyone’s perspective.  I cherish hearing of success stories and of fishing accidents that reveal people who are so incredibly happy and “living”.

*Patient gave consent to have this story shared.