The Unfortunate Privilege of Emergency Medicine

I have had the unfortunate privilege of watching an 8 year old die of cancer.
I have had the unfortunate privilege of treating a child for withdrawal from narcotics.
I have had the unfortunate privilege of reporting sexual and physical abuse in addition to neglect.
I have had the unfortunate privilege of delivering a stillborn baby to a weeping almost-mother.
I have had the unfortunate privilege of diagnosing young and old women with incurable diseases.

I say unfortunate for obvious reasons. I say privilege for many.

First, I say privilege because I am a Christian and believe in a God who can do anything. He allowed these people into my life, and me into theirs, for the specific moment we would interact...around disease, despair, or death.

I say privilege because I am a fan of humanity and am daily humbled by my patients and their families. That 8 year old boy -- I'll never forget him, sitting in his hospital bed with the face of a marble cherub, both too pale to be alive and too calm to be facing death. That withdrawing child, uncomprehending his suffering but ever so amenable to my intervention. They endure. They persevere. Per severus - the Latin for "through strictness." They emerge, changed, straitened, perhaps, but somehow intact.

I say privilege because few are allowed such access to such people at such times. They say on average the abused woman presents to at least two physicians before the third (or fourth) asks if she is safe at home. They say up to a quarter of known pregnancies don't make it to delivery alive. Who knows how many pass unknown. So to be there, then, with them, is lofty turf.

I say privilege because it costs a lot to live here. If medical training is the selective destruction of parts of your humanity, its practice reveals you are maimed. We can never return to the glory days of ignorance when big disappointments were missed vacations or having to stay inside on a beautiful day. It's not that doctors don't indulge in self-pity. We do. It's just that perspective comes swiftly on the wings of inoperable lung, pancreatic, and brain cancer...of terminal emphysema, cirrhosis, or kidney failure...of devastating mediastinal or cardiac trauma. Every day is a gift. Every day is priceless.

I don't know if I can afford this unfortunate privilege, but I wouldn't trade it for the world.

The Power of Words...And Moving Pictures

http://framework.latimes.com/2011/09/29/emergency-room/