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Medical Humanities

Joining the Fragments

Accompanying painting by Sohi Mistry

Daphne Lo

It was 1 a.m. and I was battling emotional and physical exhaustion while evaluating a patient in the emergency department on a busy float night. My text message alert kept distracting me as I attempted to assess his abdominal pain. I admonished myself for not silencing the ringer. Again, it whistled. Irritated, I glanced at the screen, “Go to the ED. NOW.” I then heard a rush of gurneys and moaning on the other side of the curtained glass door. As I stepped into the hall, I froze. In front of me, a fellow internal medicine resident and several emergency department physicians intently studied a woman’s bloodied leg. Beyond her was a bumper to bumper traffic jam of gurneys carrying more patients with variously damaged body parts. Policemen were scattered among the injured, brandishing notepads and frantically scribbling down answers. Above the chaos, a voice announced implementation of the disaster plan. “Just start seeing people, anyone,” said a wide-eyed emergency department attending. What just happened?

I entered medicine deeply believing in its power to change the world. Too quickly, I learned of the power of healthcare to deepen the divide between the haves and have nots. Too often, I felt the guilt and pain of rushed hospitalizations and shaky follow up plans because of high patient volume and unreliable payer sources. Despite my best efforts, my nascent medical career was shaped more by my failure to right the injustices of a fractured healthcare system than my ability to help my fellow man. 

I began evaluating gunshot wounds and fractures. In an eerily quiet corner of the emergency department, I found a boy lying on his stomach. He anxiously told me he felt something in his back while he ran out of the movie theater. Glancing down, I spied a small, neat bullet hole near his spine in his right lower back. “Does it hurt?” I asked him. “No, it doesn’t hurt too much, just when I move.” I felt like hugging him but panicked and stopped. I did not know if it was safe to hug him when he could be hemorrhaging into his abdomen. As I had done with each person with a sprained ankle, gunshot injury, and fearful face that night, I smiled and said, “We’re going to take care of you.”

Despite the cracks, there are times when even a broken system can cobble itself together and soothe the physical and emotional wounds of humanity. We rush to natural disasters to help strangers mend and rebuild. We risk life and limb in war-torn countries to bring a form of security and stability to those of different races and cultures. And, on a hot July night, medical professionals of every stripe pulled together across discipline and profession to treat the injuries of four dozen people hurt in a tragic summer theater shooting.

Upon the boy’s return from radiology, the emergency department attending, on-call surgical resident, and I dissected each slice of the boy’s CT scan. We searched in vain for the shredded abdominal organs and severed spinal cord we dreaded would be there. After what seemed like an eternity, we finally convinced ourselves of a tangential bullet tract through the boy’s abdominal soft tissue. The bullet had missed every single one of his internal organs. This boy will participate in school sports, dance at his prom, cross the stage at his graduation, and walk at his wedding. I am not a religious person, but after realizing the enormity of all of this, I almost dropped to my knees and prayed.

On my 382nd day as an internal medicine resident caring for a half dozen trauma patients, I found renewed faith and regained hope in the healing power of medicine. On that unforgettable night, regardless of specialty or training, administrators and employees pulled together and stretched our physical, mental, and emotional capacities to mend the wounded before us and start the rebuilding process within a community and ourselves. 

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