'Either You Wipe Those Tears or You Leave Right Now'

I had just gotten cleared to start my first clerkship as a third year medical student. As a Caribbean student, that meant moving to another state and leaving everything behind. I said goodbye to my family in California and made my way to New York. I’d been to New York many times during the summer but this was different. I had never experienced a true winter season before and of course, I was unprepared and underdressed. Nonetheless, I found housing within a mile walk of the hospital and gave myself pep-talks every morning as I walked in the snow about how I was here to save lives!

I’ll never forget my first week of third year. I was in the Emergency Department (ED), trying to help out wherever I could and absorb as much as I could in such a fast-paced environment. I loved being in the ED. The high intensity, high acuity, and uncertainty of what would present through those doors was fascinating. I felt like the patients were more vulnerable, genuine, and just wanted to be taken care of. It was in that first week I thought, “Maybe I could be an Emergency Medicine Physician one day.” Little did I know, that in that same day, I would have a temporary change of heart.

It hadn’t even been more than an hour since my shift started when my attending received a notification about a trauma case coming in. A few minutes later, paramedics came rushing in, along with what I presumed to be the patient’s family members. One of the paramedics was pushing the gurney, the other was holding an oxygen mask over the patient’s face while the third paramedic was trying to rapidly explain what happened. I couldn’t make out what he was saying. Everything was happening so fast and it all just felt like a blur. I just remember being pushed aside as the entire medical team rushed into the trauma room. There must’ve been about 15 people working on the patient as his family stood on the side, crying and screaming hysterically. I kept standing on my tippy-toes trying to get a glimpse of the patient and trying to figure out how I could be useful. I remember seeing a man lying there unconscious with his entire face and head covered in blood. Turned out he was a construction worker in his late 50s who fell off of a ladder from a three-story building.

In my mind I’m thinking, “Oh man, this looks bad but people have survived higher falls, he’s going to be okay.” Within minutes, the patient was in hypovolemic shock. He was quickly intubated, two IV access sites were placed and a foley catheter was inserted as the neurologist and radiology techs made their way into the already too-crowded room. I wasn’t sure what to do in that moment and my heart felt like it was going to jump out of my chest. But I quickly threw on a sterile gown and gloves and dove right in. I remember helping remove the patient's clothing and taking off his paint-stained work boots. I looked over to hear my attending call out, “1mg Epinephrine IV push.” He repeated it three more times and there was no response each time from the patient. After about 45 minutes of trying to resuscitate the patient, I heard my attending say “TOD 9:07.” Just like that, the patient was gone. I felt paralyzed in that moment and I immediately felt warm tears pouring down my face. I tried to stop, I wanted to be strong and professional but I couldn’t. I just couldn’t help myself. I’ll never forget the words my attending told me that day when he saw me crying. He said, “Either you wipe those tears off your face or you leave the ED right now.” Out of total fear and complete shock, I quickly wiped my face dry and took a few deep breaths to try and calm down.

I looked over at the patient’s family who were later identified as his three children who were all at work that day with their father at their family’s construction company. They were all crying over their dad’s body, clearly in disbelief. I didn’t know what to do in that moment. I just stood there watching them hug their father and all I could do was think of how that could’ve easily been my father.

I made a sacred promise to myself that day. I told myself that I would never allow medicine to make me cold, jaded or apathetic. I pray that I always find compassion, kindness and treat every patient as if they were my own family member. Every time I have a frustrating or an overwhelming day, I think back to that moment in the ED and the promise I made to myself. It was definitely a life changing moment.

Dalal Budri is a 4th year medical student who enjoys poetry, hiking and cooking. She's interested in Emergency Medicine and hopes to do a fellowship in global medicine.

Illustration by April Brust

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