It’s Ok to Cry Doc…Empathy is In Vogue

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Being in the boys’ club of a surgical field sometimes has its moments. Like when you realize it behooves you not to cry. As a woman, especially, I still think it’s true but every now and then it’s ok to be human and let go. I remember my trauma ICU (intensive care unit) call, which I really enjoyed. It was a special place with over 30 beds separated only by curtains and a few isolation rooms. If you could run a 30-bed SICU at a level 1 trauma center in the third largest city in the country, you could do just about anything! There was just one thing you had to know about the surgical ICU…no one died in the OR, it was bad form and bad luck. The team might bring a patient out of the OR coding them, but it wasn’t until they crossed the threshold of the SICU that time of death could be called.

On one particular night, a patient became the exception to that rule.  He never made it out of the OR due to extreme blood loss and internal organ damage, thus never entered the SICU. His body was taken directly to the morgue as Unknown 321. So on my SICU admit roster was Unknown 321. The next day a large family arrived and said they had driven nearly 12 hours over night because they were told a family member had been in a terrible head-on motor vehicle accident with an eighteen-wheeler. They thought he was alive and in the SICU and, unfortunately, I had to be the bearer of their bad news.

As screams and wails filled the corridor of the fourth floor of hospital, the mother asked to see the body. I knew her request was valid. She wanted proof it was truly her son. I told the priest privately that the body was not in the best shape and that she may not want that image to be one of her last. But with an innate, maternal due diligence, she insisted.  We walked to the elevator, and as many of the family members that were present who could fit, got on. As we descended to the cold and gray basement, the patient liaison informed them that only three could go in.

The mother boldly stepped forward. I admired her courage but feared deeply for what she was about to experience. No mother, regardless of their age, should ever have to see her child like this…in a morgue. The father and brother also stepped forward as support. As we entered the room, a swift silence fell. The pathologist opened the bottom stainless-steel door and pulled out a tray with the precious remains of Unknown 321.  As he unzipped the bag, sounds that I will never forget, heaved forth from this woman, a mother.  The father abruptly turned his back and stood against the wall, because he couldn’t see his son like this. The brother walked forward to console his mother but as soon he saw his younger sibling, he dropped to his knees in grief. When I thought it couldn’t get any worse for this family, through the cinder blocks of the adjacent wall and down the hall, I could hear the distress of the remaining family members as they overheard the pure torture that the mother and brother were experiencing.

She asked me to remove his breathing tube. I cleaned his swollen face and watched stoically, with tear-filled eyes, making deliberate efforts to maintain my professional demeanor. As the mother slowly found her way to the floor and lifted her child into her arms one last time I felt a gentle touch in the small of my back and a whisper in my ear…”it’s ok to cry”. The chaplain reminded me that I was human, too. And if there was ever a time to not be “professional,” it was in that moment.  As I was given permission I allowed the tears to stream down my face and empathy for this family overwhelmed my heart.

This may not apply to everyone. Some of you may be big and bad or even calloused to events that happen to you and those around you in the world of medicine. I, however, must remind you of Rule 22 (The Rules of Medicine): It’s Ok to Cry. The reality is being able to embrace your humanity and show emotions are essential to being able to effectively take care of any life, particularly if they are Unknown 321. This, is what you signed up for. You may not do it openly, or every time, but at some point you will or should cry, and it is ok! In life, even as adults, sometimes we need a reminder or just permission.

Emotions are part of this human experience and you will definitely encounter each and every possible human emotion during your medical training. In fact, some emotions happen simultaneously or repeatedly throughout the same day, if not the same hour. Medicine can be intense. So there is balance in knowing you are not invincible and you have permission to express the essence of who we are while still knowing how to control them when needed.

Medical professionals are human too.

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