I work as a resident in Australia’s busiest emergency department. Well, it was the busiest at a recent count anyway. The department is housed in the city of Gold Coast. The city sprawls across a beautiful stretch of beach. When I wake up, I turn my head to see the sun hanging out over the Pacific ocean. I can’t think of a better way to start my days. Whether it’s on the backdrop of a sun-kissed city or snowstorm in Boston, though, I sometimes think about the shared experiences that connect doctors across the world. No one will understand the depths of our stories the way we can for each other. Even still, my days have some different twists. On a summer day in 2020, I was on my way to work. It was the middle of a run of evening shifts. After waking up, I took about two and a half hours to get ready. There were a few things happening at home that day too. It was an unsettled environment. I got out the door and into the car, which again took around ten minutes that day. My carpark is too tight for me to get into the car, so we moved it forward a little. An impatient neighbor driving through the car park beeped his horn at this affront, then stared at me. On our way to the hospital, it started to rain. I felt chilly already, even just by looking at the water hammering down outside. I had a small wound on the left leg, which was presumably causing pain. I was pouring sweat on the right side of my face, making me feel even colder. I turned up the heater to the maximum. Fortunately, the car had dual-zone climate control. The person driving me didn’t have to get toasted too. We pulled up at the drop-off zone for the department. There were cars everywhere, specifically in the undercover area. I got out in the rain, becoming soaked in the process. I knew that I was going to be shivering intermittently for a good part of the shift. I was allocated to the resuscitation pod, where the sickest patients are seen. I wandered in and found a computer that was dictation-enabled. After plugging in the dictaphone and setting everything up, I clicked on the first patient. It was a lady with symptoms of a stroke. I took a handover from my boss, who had the ball rolling, then went to the bedside. The lady had trouble talking, but was calm and friendly. She was about to be taken into the CT scanner. While the scanner was running, I took a few seconds to center myself. I was cold in a way that struck deep into the bones. I was thinking about things at home. I made a conscious decision to clear my head and get in the game. The radiology trainee came over to review the scan. Indeed, there was a stroke. The patient was stable. We started management. I examined the lady further for some other symptoms that her daughter mentioned. I’ve learned how to streamline an effective examination without the use of fingers. I talked to the family about what’s happening. The patient’s daughter told me that she saw me on a TV segment. She told me that she was glad to meet me and happy that I’m looking after her mother. I smiled inside and outside with gratitude. Two more patients told me the same thing that day. I wonder if they realize what an uplifting effect their words had on me. On that shift, I saw another patient with a stroke immediately after the first one. They were far more distressed and aggressive towards the staff. I understood. Losing control of everything suddenly is terrifying. The interventional radiologists took her for a clot retrieval. I then saw an unstable patient with gastrointestinal bleeding and another with sepsis. That day, all my patients were quite ill. Eventually, things settled down. I wandered up to the trauma office, where I know a hairdryer to live. I blasted it to dry the last bits of wet scrubs that remained. I loved the heat. I didn’t want to leave but needed to get back to the floor. I eventually finished my shift and left the hospital, again blasting the heater on the way. I was still a little cold. I decided to stop by at a restaurant downstairs from my apartment to get dinner. I wanted to tune out. I grabbed a quick meal, went home, and started the process of showering and getting into bed. Before I fell asleep, I dealt with some tricky things at home, knowing that I have to wake up in several hours for the next shift. You might be wondering, why is this guy so cold? Why would he sweat on just one side? Why does it take him so long to get ready? Well, I like to look good. But also, I have a spinal cord injury. Many things take more time to do. My fingers and everything below the chest is affected. Thermoregulation is too. The sweating is from the autonomic nervous system malfunctioning in response to pain. Despite the intricacies of working as a doctor with a spinal cord injury, I wouldn’t give up this career for the world. I love what we get to do. In the challenges, though, I’m not alone. There are many doctors around the world with a raft of chronic conditions, affecting both the physical and emotional well-being. On top of that, life still happens. Loved ones might still become upset. The neighbor might still beep their horn. Rain will fall. Even though we know the most intimate details of our patients’ lives, we rarely know what goes on behind-the-scenes in each other’s lives. Some of us deal with invisible things like cancer or depression, a lot of the time alone. I’ve more than once talked with the intern secretly struggling with depression, the resident who had cancer, or the physician who’s marriage is falling apart. By examining our vulnerabilities, we can find strength – not just as individuals, but as a profession. This, though, is contingent on us being kind to each other and celebrating the diversity of our lived experiences. Dinesh Palipana is an emergency medicine resident in Australia. Source
