A Surgeon’s Survivor’s Guilt

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My heart tells me I lost them.  My brain tells me I never had them to lose.

One of my mentors has said that all trauma surgeons have their own personal graveyard, filled with patients we couldn’t save, and families’ hearts left broken.  A truer statement has never been said, and this weekend, this trauma surgeon’s graveyard has increased yet again.

The feelings that accompany this increase are always varying and deep.

There is anger.  True wrath.  When the hell are we going to figure this out?  When are we going to stop shooting one another?!  When are we going to learn that drinking and driving can be deadly?!  When are we going to start respecting ourselves, our bodies, and one another?!  When are people going to stop paving a path of destruction for themselves and others that is wide and immeasurable?!

There is sadness.  Sadness over the pain and the fear that my patients surely felt.  Sadness over the waste of life that we witness.  Sadness for the families left behind, in a new world they never anticipated.

And yes, guilt.  Guilt over being able to go home, when our patient couldn’t.  Guilt for leaving the hospital to enjoy my family knowing another family has just been destroyed.

This weekend was a particularly rough one for myself, and the hospital at which I work.  Although to most people around the country, it was just another act of violence, to myself and our community, it was felt deeply.  Every person in our hospital was stung, upset, and shocked.  Everyone knew what happened – I received touches on the arm, knowing hugs, and reassuring smiles.  They knew I did everything humanly possible even when the inhuman was needed, but that knowledge is a poor salve against this type of wound.

So please, if you know someone who works in healthcare – give them a hug, a high five, or even a thank you.  I have said before how we all take you, our patients and communities, home with us at night, but please also know that our lives are never the same either.  Every patient encounter alters us – sometimes subtly, and sometimes drastically.  We are changed, and we never forget.

Stay safe.

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Dear Drunk Driver, “Tonight”.

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Dear Drunk Driver,

Tonight, I am tired.

Tired from lack of sleep, tired from the long hours, and tired from bearing witness to your destruction.

Tonight, you caused an accident while under the influence of alcohol.  And, you are badly injured, requiring emergency surgery.  Your liver is hard, cirrhotic, and unforgiving.  Although I can get you through this first surgery, I know you will not survive.  I know over the next few days, your broken and beaten liver will begin to fail, your kidneys will stop working, you will start bleeding from every orifice of your body, and you will die.

Tonight, I met your family.  They thought you had quit drinking, but they asked, and I answered, “Yes.”  “Yes” you had been drinking and “yes” your liver carries the scars of your addiction.  “Yes”, it is likely you will not make it.  I saw the hurt cross their eyes, the anger, the embarrassment.  And then, the part that I dread the most, the part I was hoping wouldn’t happen – but it always does… They asked about the accident.  They asked if someone else was injured.  They asked if the other person was okay.

And a fresh, new, searing pain begins, because…

Tonight, you killed someone.  Someone’s husband, wife, father, son, mother or daughter isn’t coming home.

I see a shadow cross your daughter’s soul as her mascara weeps down her face and stains her arms.  I see your son’s image of you crumble upon the impact of my words.  I see their shame, their sorrow, with no outlet other than tears.  Their heartbreak reaches out and stabs at me, their confusion begs my sympathy.

Tonight, another family is being informed of their loved one’s death…  Their souls, and hopes, and dreams are extinguished with the two words, “I’m sorry”.

Tonight, you are blissfully unaware and asleep…disoriented, medicated and sedated because of your own injuries.  But while you sleep, perchance you dream… of all the wreckage you have caused.

Tonight, you have blazed a trail of tears.

Tonight, I am angry.

Angry you didn’t know better, angry at all the hurt you have caused.

Tonight, I am angry.

Because I know this will happen again.

When does this end?  When will you stop assaulting your body, your family and your friends?  When will you stop tearing through lives, ripping out the hearts of people you know and of people you don’t?

When will you stop?

Please, let it be-

“tonight”.

Sincerely,

Your trauma surgeon

** This writing does not describe one particular patient or event, but is the unfortunate result of many patients and experiences I have had over the years. **