We don't save lives; we palliate the dying.
In just over a month of working in the ER, I have yet to pull someone back from the grips of death. In fact, the Reaper has yet to make an appearance in any of my workdays. (Though he has been ever present in someone's day in the ER) I have not pumped on a chest in order to force the blood from the ventricles to the rest of a gasping body, dying for air. I have yet to administer the epinephrine, and the life saving shock of 360 joules to an ailing heart.
I doubt I've saved a life. But I can say with a high degree of certainty that I've crushed more than one.
I recently had a very pleasant 60-something gal visit me in the ER. She was sent to us after being seen by her regular doctor earlier that morning for ankle swelling that was noticed by her husband while eating breakfast. Her primary care doctor did an EKG and and exam, and told her to come to the ER to get looked over a bit more thoroughly.
This is precisely what I did. With my words, my hands, and the tools at my disposal, I did my best to uncover what might have been causing her swelling. And, to keep a long (and as is usually my mode of operation) wordy, story short. I discovered that it was not her heart, nor trauma, nor a clot that was causing her ankle swelling, but was a result of ascites. Her liver was full of lesions, and her enzymes were quite elevated.
They were metastatic lesions; spread from another, primary tumor site- at least, this was the read of the CT by the radiologist.
"SHI........" I mutter when reading the CT report.
By now, not only was her husband present, but a handful of family had amassed to accompany their hospitalized family member. It wouldn't be easy, for any of us involved.
All who stood in the cold, curtained room of 5A, were forever changed by the news that passed over my lips. The words penetrated each of the vastly unprepared masses of flesh in front of me like shrapnel ripping through unsuspecting soldiers, blown away by a hidden IED... placed by the most vicious of insurgents.
I am the insurgent.
My words are the Improvised Explosive Devise.
I exit, leaving destruction, smoke and confusion in my absence.
"Saving lives in the ER..." or, what do I do at work? 'Save lives, duh!" These are things l hear, and read from time to time from other health care workers, none of which ever seem to be doctors, PAs or NPs. Though I doubt this to be the case.... that souls are being grasped from the edge of the abyss, and snatched back by my fellow healthcare troops, I hope this is happening. I, however, have no such delusions of grandeur. I realize that I may heal certain conditions, treat the sick, and palliate those in pain.... but I do not save. I am no savior, nor do I jest about it.
I suppose those who have been in the position that I was, find it difficult to say that they've saved lives. When you, in some sense of the word, have killed someone, there are no number of souls you can pull from the fire that will be enough to claim status as a life saver. There is no more room for playful, and boastful banter.
If I do anything comparable, in permanence, importance, and power, to that of saving a life, it is to recite death sentences.
I am someone's bearer of bad news, bringer of death, and Reaper himself.
Don't misunderstand, I love my job. I love what I do. I'm happy that I've found myself to be where I am today. I just realize that I'm only prolonging the inevitable. I'm not saving lives, at best, I'm simply making them longer.... perhaps long enough for me to tell them that they are going to die from their metastatic cancer that has spread to their liver.
Only if I'm good enough to preserve them for that long, and, only if I'm that unlucky.
I guess you could say we're damned if we do, and damned if we don't.
I wouldn't, but you could.
