Learning And Refining Key Clinical Skills For Residency And Beyond: Lessons Learned From The Fulbrig

Mom wept silently as she stared at her dead daughter — quiet, near catatonic. I was prepared for a sharp scream.

But she sat there quietly. She was staring at her beautiful but lifeless daughter.

Young with long black hair and 21 years old. She was mom’s pride and joy.

The daughter got into yet another fight with her boyfriend. They were both in college dorm apartments. She couldn’t stand the screaming anymore.

As a little girl, her dad would scream at her mom. The screaming always haunted her.

She remembered hiding under her bed, hugging her teddy bear, crying. Make them stop, make them stop!

Her boyfriend wouldn’t stop screaming. She opened the window in her small apartment to breathe in fresh air. And in an irrational decision, she jumped out the window — five stories down.

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The boyfriend called 911. He was in disbelief and packed a night bag of clothes for her with pajamas and socks. And he followed the ambulance to the ER.

The trauma team was activated, called overhead. STAT. Blaring out: “Code trauma ER, code trauma ER.”

She laid lifeless on the stretcher. Her face was perfect. But her organs were destroyed.

Carefully intubated, they rushed her up to the surgical trauma ICU.
And she was mine.

I looked at her and knew.

I immediately said to the trauma surgeon, “She’s dead.”

The trauma physician said, “I know, I know, but we have to try. We’ll insert a few chest tubes. Maybe a pneumothorax.”

His residents stood by and watched this trauma team work quickly and meticulously.

I hooked the chest tubes up to suction — IV, normal salines flowing rapidly through her veins.

No response. No BP. No pulse. No respirations. It was just a vacant stare that left this earth 30 minutes ago.

And the trauma surgeon, after placing bilateral chest tubes, pronounced her death.

The police went to her mother’s house to bring her mom in.

I never did well with young people. They always broke my heart.

But I was preparing for the mother to be hysterical.

I was prepared to hear a blood-curdling scream.

The mom walked in slowly.

She sat in the chair I provided her. She was staring at her daughter. She sat silently. Not a word. Not a scream. Almost catatonic.

Her beautiful baby girl.

Gone forever.

The mom stayed for one hour. I approached her but didn’t say a word.

It was a sacred silence.

I put my hand on her shoulder. She reached for my hand with her trembling hands. Holding my hand she silently wept.

I wept also.

After one year working in this surgical-trauma ICU, I swore I saw it all. But my heart couldn’t take it anymore.

My steel heart had crushed into a thousand pieces.

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