Nowadays my family and I often watch TV series on DVD because we appreciate the closed captions and lack of commercials. About two years ago we got into classic TV drama series with "Picket Fences". Now "St. Elsewhere" fills our viewing time. In the process, our teenage and twenty-something offspring seem to enjoy glimpses of life in the "old days," which I find entertaining as well.
"Did you ever do that, Dad?"
"Actually, yes." The TV show realistically portrays both the science and art of medicine at the time...including now obsolete practices like intracardiac adrenaline.
"No way could someone be in labor and not even know she was pregnant! Right, Dad?" Well, yes they can. Happened twice in my practice. Both full-term. Truth can be stranger than fiction.
Watching "St. Elsewhere" over twenty years later brings back a flood of memories, poignantly so because quite a few years have passed since I worked a regular shift in the emergency department. Few places on earth put you so close to real life drama, to personal tragedy and triumph. I still remember some of the patients I saw and treated. My heart still aches recalling the times I had to tell a family that their loved one had passed. "We did all we could" sounds even more trite now that it did then. But I also recall the thrill of feeling a faint pulse where seconds ago there was none, the welcome whisper of a scant breath bringing new oxygen to an almost dying body, the return of a blood pressure as bleeding was stopped, and the joy of telling an anxious family that all would be okay.
As a young narcissistic emergency physician I was hooked on the adrenalin rushes of those challenges and triumphs. A good shift was marked by the numbers of major trauma and cardiac patients seen and resuscitated. (How I pitied my internal medicine colleagues who must deal with chronic, unexciting maladies day after day after day.) But as the years went on I experienced more tragedy than triumph. The dramas of the human condition played out in the ED often reflect the one-to-one statistical correlation of life to death. The only variable is when and how one will die. When that final moment occurred on my shift, I was never empowered to change destiny. In death or in life, I was simply the instrument of a higher power's plan.
Once I recognized and accepted that reality, I matured both as a physician and human being. Success was no longer measured by blood pressures and respirations, but by the degree of compassion and empathy given to fellow humans in times of life crisis. That was when I became not just a physician, but a real doctor, and where I found the true meaning of my honorable profession...rooted as it is in the Latin word meaning "to teach" and reflected in the tenets of the Oath of Hippocrates.
The young resident physicians portrayed in "St. Elsewhere" are not yet real doctors, although some are further along than others. Their fictional mentors, Drs. Auschlander and Westphall, do understand that their professional value is fully vested not in themselves but in service to their patients. Their vital role in the drama is to instill those values in the young physicians who follow them. Some will get it, and their careers will mature. Others will not, just as Chief of Surgery Dr. Mark Craig still doesn't understand it, and never will. Here too fiction reflects reality, and little has changed from the 1980's to today.
I ardently pray that today's Auschlanders and Westphalls, whoever and wherever they are, will prevail.
2 comments:
Who ordered Chinese?
Just enough to keep my nose respectable.
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