Talking to people outside of the medical profession about what I do at work, I often get the reaction that I am callous, cold hearted, or insensitive.
After all, how could a person talk about going to codes, calling time of death, talking to patient's families about withdrawing care, how could a person do all these and not break down crying without being an insensitive, horrible person?
Because that's what I do. In my job, I have frequently been the face associated with the worst news families may ever get. I have told families and patients horrible things, such as diagnoses of cancer, brain damage, and worse. At the bedside, I do my best to be sensitive, to be professional, to be available in every way possible.
Step away from bedside, and it is common to be casual and impersonal about the situations. To talk about what happened in non-emotional terms.
Thus, the accusations of being cold hearted.
But I promise that is not the case. After all, I'm the girl who cries at Johnson and Johnson commercials, who cried in front of a Monet painting, who gets choked up with each goodbye to my boys. I gush over baby animals, I tear up at weddings and births. I'm not an insensitive person.
But at work, it's just that...it's work.
When I walk through the doors of the hospital, I do become detached, objective. I think it is essential to become this way. This is what allows us to be good at our job, our ability to be objective. I have to focus on the physiology, on the numbers, and not the person. When I'm transfusing blood as fast as I can during a trauma case, I have to think about normalizing the blood pressure and the labs, and not about the hopes and dreams the patient may have had. When I'm placing an emergency airway, I have to think about the algorithms, and not about the patient's history and stories. When I arrive at a code, and chest compressions are started, when I push on a patient's chest and feel the crunch of breaking ribs underneath my hands, I have to focus on what I'm doing, and not on the family standing outside the door.
If I think about all the other things, all the stories and family and hopes and dreams, there is no way to stay objective, to think about what needs to be done.
The other part of this is separating the horror stories behind every door at work from the domestic happiness of my home life.
There has to be a way to call time of death and console a family, and then leave, drive home, walk through the door, sit around the dinner table and ask about what happened at school. A way to separate the seriousness of my job from tickle tag and story time with my boys.
I recognize the sadness and the hugeness and the terribleness of what so often goes on within the hospital, of what I am called to do.
But at some point, I have to go home. I have to go back to being a normal person. I cannot allow the sadness I see to become my sadness. This is the only way to not only remain good at my job, but to remain sane.
So, if you ever hear me tell a story about a terrible thing that happened at work, and I don't break down crying, if I don't seem that I'm falling apart, it's not because I'm cold hearted. It's because this is what is required.
This is how I survive.