Every clinician has a moment in their careers that makes them stop, reboot, reflect and maybe even change direction completely. Such moments can be life changing and can be a hair’s breadth from the individual leaving health care for good, as so beautifully articulated by Adam Kay in his bittersweet book This is going to hurt.
On Christmas Day more than a decade ago, my 10-year-old son received a present from his nan; matching Bart Simpson boxer shorts and socks. He loved The Simpsons and he wouldn’t take them off. They were cardboard-esque and smelled of brie by the time they got their first wash.
Some weeks later, on a busy early evening in ED, the Medic 5 phone rings, also known as the Bat Phone or The Red Phone, this is the phone that raises the adrenaline and prepares you for the unknown. This time it is an emergency called in by the ambulance service. Whoever gets to the phone first delivers the news like the first round of some sad game of Chinese whispers.
The call is bleak: several children walking home have been hit by a lorry. All of the children have serious injuries.
They arrive, in order, into resus. The trauma teams are ready, and I see with dismay that I am paired with an anaesthetist I don’t much like. Things have always been strained since he overheard me calling him pompous once when clearing his mess up in resus- one of those “he’s behind me isn’t he?” moments.
We are with the most seriously injured boy, and it soon becomes clear he is so seriously injured that he will die. As we undress this little boy, we are silent, listening to instruction and following the direction of the trauma consultant. The eye contact says it all and our hearts are heavy.
Then suddenly I stop. He is wearing Bart Simpson boxers shorts and matching socks.
I see my son, same age, same boy; I feel anxious, panicky, light headed. My colleague takes over, she cuts through the clothing and throws it unceremoniously in a grey plastic bag emblazoned in large font ‘PATIENTS PROPERTY’.
Property? No… stop! That was a Christmas present from his nan.. he loves those socks…
I hear his parents sitting by his side; pleading for him to be strong, to get better, they were going to surprise him, but they say to him, we will tell you anyway. His birthday present of a new bike had arrived ready for his party at the weekend.
Yes- please get better .. its your birthday.. you have a bike!
The tears begin and they don’t stop – I scold myself: don’t cry in front of his parents, it’s not about you. Stop it!
I take a break but am overwhelmed by this terrible feeling of intense sadness.
The anaesthetist walks me to the League of Friends visitor’s bench outside the department – in memory of Ethel who lived to the ripe old age of 96 – and buys me a coffee from the machine, – it tastes like creosote- and lights a cigarette that we share (I don’t smoke). Not much conversation takes place, but he squeezes my hand before he goes back in. It actually means everything to me. I say sorry for calling him pompous but I don’t think he hears.
I return to the triagebooth to book in a party of giggling hens who have bought in the bride to be after she has fallen off her 4-inch heels- they say they like my scuffed Doc Martens and invite me to join them later…
The next day I replace my son’s Bart Simpson socks and boxers with a Spiderman set from Asda.
From the distance that the years have given me, I see now how pivotal this incident was in so many ways. I will never forget that evening – forever logged in my hippocampus, amygdala, and medial prefrontal cortex. I left ED the next year. I think if I had had counselling maybe I could have stayed and I wholly admire those who manage on a day to day, week on week, month on month basis to continue after experiences like this. Ironically though ED still remains the happiest, most rewarding time of my nursing career. But the highs come with lows; it’s a rollercoaster life. I now realise that that one event can trigger a ‘post traumatic reaction’ despite years of managing sadness or trauma.
Looking after and looking out for each other is paramount; small acts of kindness such as making a cup of tea go a long way. Sometimes less is more – although taking up smoking is not advised as I felt very sick afterwards. I guess the final salutary lesson from this story is a reminder to always check that the person you are moaning about has not come back to resus to retrieve his stethoscope… come to think of it, maybe that coffee was creosote after all….