Crozet Annals of Medicine: Blueprints

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The ER can be an overwhelming place. So many patients, so much suffering, so much need. I have been working in the ER for a long time and yet once again today I was overwhelmed by a patient’s suffering. Emotionally depleted, I turned and left the room. As I exited into the corridor, I came face to face with two nurses. They must have seen something in my eyes because they didn’t say anything in greeting. They just held my gaze as I regained my composure and then after a time nodded and gave me warm smiles. One patted my shoulder. Then they entered the room I had just left.

This is how, together, we keep doing this work. We understand each other. We recognize in each other the stresses we all face. We actively monitor each other’s well-being. We have an unspoken bond due to our shared experience that is a form of constant support.

On a related note, over the past two and a half years something interesting has happened in the hospital. We have become a tribe. The hospital, as dangerous as it is (Covid) has become a refuge for us. It is the place where we can control the narrative, where we can agree on a common set of facts. It feels like the public has lost the thread on Covid and doesn’t understand the threat that Covid still is. New cases now top over 100,000 per day. But away from the public, in the hospital, we are united in purpose and understanding of this. This is a significant source of support for us. We have a shared mission.

On another related note I have become enamored of the hospital after hours. The lights are dimmed and only the essential staff are around. In the quiet hours of the night the teams do their work in a calm and unhurried manner. And it is always teams. In groups of twos and threes and more they roam the halls, teaching each other, supporting each other and dividing up the sometimes difficult work to make it a little bit easier. They come when I call for help and they help with a grace that soothes my team’s ever-present and wearying hypervigilance. 

We support each other in small ways with small solicitudes, and we support each other in big ways. Never has this been more obvious than during the pandemic when we have had to cover each other’s shifts as the virus successively took many of us down.

We don’t have an on-call list for the physicians in our group. We have never needed one. If one of us falls ill they notify the group and someone takes the shift. 

My point in sharing all of this is that these are blueprints for how to thrive in the trying times we now face. Inflation is running rampant, supply chain shortages impact everything, children are being massacred in their schools, Covid continues as background noise to everything and our overall response to all of this is to become more uncivil and polarized every day.

But if we can create a space in the chaos of the ER where we support each other in these ways, surely we can do it in the less challenging spaces we live much of our lives in. 

So, try this in your daily life. Watch for signs of stress in your friends and family, your coworkers and your colleagues, and even the people doing business with you. Offer support or just simple understanding. Everyone is fighting an unseen battle. You just have to look carefully to see it. 

Try to uncover your mission. Find ways to see it as the shared mission it likely is. Recognize that team of people who participate in your shared mission. Collaborate with them.

Work in teams. Teach one another, learn from one another. Share the load. 

Come when asked to help. Help with grace. Watch it soothe those around you who may be struggling and stressed. 

And above all be the person who picks up the shift for the one who can’t. Someday you will be the one who can’t. 

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