The truth about the hardest part of my job

I get asked a lot of questions about my job.  Simply stated, when asked “What do you do?”, my response, “I’m a trauma surgeon” is often a conversation starter and questions quickly ensue.

 

“Do you work in the ER?”

 

“What kind of surgeries do you do?”

 

“What’s the coolest thing you’ve ever seen?”

 

“Do you see a lot of gunshot wounds?”

 

And so on and so forth.

 

And in general, I try to be as open and informative as possible.

 

There is one question, however, that is often asked and rarely truly answered.

 

“What is the hardest part of your job?”

 

Admittedly, as much as I love my job, there are some seemingly glaring downsides.  I never really know what I am going to do any given day.  I work long hours…. like, really long hours.  Like, think long hours then double it.  I work days, nights, weekends, holidays, and birthdays without any regularity or consistency.  My job is intense, stressful, and I am a first-hand witness to the destruction human beings inflict not only on each other, but also on themselves.

 

But none of these are the worst part of my job.

 

When someone dies from a traumatic injury… well, for lack of a better word, it’s traumatic.  It is sudden.  It is unexpected.  It is unforeseen.  They woke up that morning, put on their socks and shoes, and walked out of their home… never realizing they would never see home again.

 

When someone dies from a traumatic injury – they are brought into the hospital, and we try to save them.  We place tubes, we place lines, we perform surgeries.  But this flurry of activity isn’t just occurring inside my operating room.  Outside of these sterile walls, police are attempting to identify the patient, then the next of kin, then get in contact with the next of kin, whom are typically told some version of what maybe caused the injury, and the family come flying into the hospital – scared, hopeful, sometimes in groups, sometimes alone and always unknowing.  They have no idea what type or severity of injuries their loved ones has, because all of this occurs typically simultaneous with me diagnosing, treating, and operating on those injuries.

 

When my patient dies, after I am unable to save my patient, I call the time of death. Then, I call our social worker to see if family has been found, and if so, to find out where they are.  They are then brought to a room… still anxious, still nervous, still unsure of what has happened or what is happening. They wait to talk to “the surgeon”.  They wait with questions, thoughts, and words crowding their brains, reassuring themselves that whatever it is, it just can’t be that bad, their loved one is needed, wanted – they HAVE to be okay.

 

And while they wait, while their brains race, feet pace and hearts ache, yearning for information…I change my scrubs, wash my shoes, check my face in the mirror – all to make sure they don’t see the blood of their loved one on me.

 

I then enter that small room where they wait, and their eyes turn to me – full of questions, anxiety, often tears, and always hope. Hope that maybe it isn’t as bad as they have feared. Hope that they can see their loved one soon.  Hope that I am going to tell them everything is going to be okay, their life will be the same… with their loved one in it.

 

My entrance into that room is the worst part of my job.

 

No, it isn’t the actual giving of the words, “I’m sorry your loved one has died”.  It isn’t the watching of tears falling or the listening to the sounds of pure, unadulterated sorrow that follow.  It is actually those moments before I tell them their loved one is dead which give me pain.  Because those moments are pregnant with possibility.  I can see all their hopes and dreams for their loved ones – the birthdays, the hugs, the trips, the children … the time.  I see the time they are so sure they will still have.  I see the time they never imagined not having.  So many possibilities… of all the things I know never will be.  There will be no more birthdays.  No more hugs.  No more words exchanged, memories created, or dreams shared.  My words, in the next few moments, will shatter all of those possibilities.  Those possibilities will be replaced by pain.  That hope will now be denial.  That sense of what life is will be lost… the life they know will be gone… replaced by confusion and bewilderment at the harsh new reality into which my words have forced them.

 

It is the moments before the tears and the anguish that is the worst part of my job.  It is seeing the light in their eyes and having the knowledge that I will be extinguishing that light.  This is what leaves its mark on me.  Because that light represents my patient… who they were, how they loved and how they were loved, all they were… and all they never will be.

 

That is the hardest part of my job.

25 Replies to “The truth about the hardest part of my job”

  1. Thank God for people like you in this world. You deserve a special place in heaven and I’m certain that when you day comes it’ll be there.
    Thank you!

    Liked by 1 person

  2. Thank you, Dr. Coleman for your insight, honesty, and humanity in describing this incredibly difficult process. Some may wonder how you can go through this time and again. But in my experience (although as an oncologist, not as a trauma surgeon), knowing that you gave it your all, did everything possible to save the person’s life, but that the injury was too much for their body to withstand provides comfort … to you, to the family, and enables you to be ready, physically and emotionally, to do it again when the next patient bursts through the doors. God bless you.

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  3. Thank you for all you do and for providing this insight into the life of a trauma surgeon. I read it and knew that it is the hardest job in the world and I thank God for you and all those who truly sacrifice a lot in your own lives to take care of those who come to you in such horrible conditions.

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  4. what a beautiful thread… I worked for many years with trauma surgeons whose skills I always admired. You have articulated the heart and soul of our work. It doesn’t rest with one person, or specialty – but all of us.

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  5. You are Amazing and I love this beautiful peace you have written. When I was still doing ob, I hated extinguishing the light Of my patients with the IUFDs . You are so strong and brilliant! Thanks for all you do
    Xoxo

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  6. 10 days ago my patient had an AFE. 9 hours later she had had a stat section with chest compressions, massive transfusion protocol, aok protocol, intubation, placement on ECMO, bilateral uterine artery embolization, Bakri uterine balloon catheter placement, another code, massive hemorrhage, exploratory laparoscopy with hysterectomy, abdominal packing and open wound. I cannot thank our amazing trauma surgeon enough for getting us all through those heart wrenching hours. My patient has survived, and yet the back and forth to her family in the waiting room was beyond emotionally difficult.

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  7. Wow! Great thoughts on how trauma impacts and wow for really breaking down the hardest part of your job! That is absolutely spot on!

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  8. Spot on. I feel the exact same way when I am about to enter my pregnant patient’s room and tell them their baby has lethal anomalies or is dead. Standing in front of the exam room door still makes me sick knowing my words are about to destroy their hearts. I thought it would get easier to do it but it sure as hell doesn’t. Thank you for what you do.

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  9. I tried from Jesse Brown VA hospital after 41 yrs. I have prayed for patients, families AND doctors. It takes a SPECIAL person to do what you do.
    I’ve seen it first hand. Thank you for your love of humanity.
    Wishing you all the blessings in the world

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  10. As a urologist, I have only had to do this once in my career. I cannot fathom having to do this several times a week. Utmost respect for all trauma surgeons.

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  11. A marvelous piece of writing. Our daughter-in-law is a pediatrician hospitalist, so deals with all of the children coming through ER- she rarely shares the awful tasks she sometimes has to perform. Thank you for this.

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  12. Respect, only respect Dr. Coleman. An articulate, moving and stunning piece of writing. As a fellow trauma surgeon… I know your anguish. And it pales in comparison to the anguish of survivors, and the anguish of families left behind after they bury their loved one. Such sorrow. Thank goodness for people like you. Stay strong and take care of yourself too. The world needs more people like you.

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  13. thank you. I work with medical students when they fail – something that happens frequently but we never talk about it. I tell myself when I see the light fade from their eyes that if I can sit with them, it will prepare them for the moments you describe. Thank you for reminding me why I do what I do and encourage me to demonstrate empathy to our amazing physicians-in-training.

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  14. Wow, so interesting to hear this from the perspective of a Trauma Surgeon. I can not imagine if you ever get used to giving bad news to a loved one or perhaps they have no one, that would be very difficult. We tend to look at you all as cold uncaring people, another patient, another life, NEXT…. but your article was written so beautifully and kind with so much love. It is wonderful to hear this story from your perspective. May God Bless you, your hands and mind, and give you the energy to continue on this amazing ride of Healing the Human Being. Thank you very much for all your hard work, your skills, your kindness, your humanness (if that is a word) to mankind. I will never look at your all the same way. Wishing you all the happiness!!

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