I remember the exact moment my medical career first became real to me.
I was a third-year medical student on my general surgery rotation, and it was my first day on call. I remember how absolutely cool it felt to wear a trauma pager and sleep in an on-call room. I felt like I was really somebody special.
We were hanging out around 11 p.m. on a Friday night in the residents’ area, eating chips, drinking pop, and waiting for a trauma alert like the ones you see on medical shows on TV. I felt anxious and excited at the same time.
Then it happened: a STAT page from the emergency department.
Our team took off running toward the ER, and I had no idea what we were about to walk into. It felt exhilarating and surreal.
We arrived at the trauma bay, and there was a young woman in her early 20s lying in blood-soaked sheets on a metal stretcher in the middle of a brightly lit room. Throngs of people surrounded her, placing IVs, checking her vitals, and performing chest compressions. One person yelled out instructions while another recorded it all.
At first, it looked like a chaotic scene to me. Soon, however, I could see that there was an order to what was happening.
I could also tell that something horrible had happened to this young woman.
I squeamishly asked a nurse next to me, in a very soft voice, “What happened?” She said that a speeding car had crossed the center median and entered oncoming traffic on the other side of the expressway. The young woman’s car had been struck head-on at 60 to 70 mph.
As I stood there, somewhat in shock and taking it all in, a senior-level resident tapped me on the shoulder and told me to take over chest compressions.
At first, I wondered who he was talking to. It couldn’t be me. I had never even performed chest compressions on a living human being before.
But he wasn’t really asking. He was telling me to do it.
That’s how it was being a third-year medical student.
As I approached this unfortunate soul, the person performing chest compressions stopped, and I took over. Her motionless, naked body was pale, and her wet, stringy hair was matted with blood. I remember looking at her eyes, which were dry and glazed over.
She looked dead to me.
I started chest compressions and could feel her chest wall give way with each compression because of the extensive rib fractures she had sustained. I continued the compressions the best I could.
This was so different from the plastic model we had practiced on in class.
I had no idea whether I was doing it correctly. No one was going to tell me. I remember thinking that I didn’t want to be responsible for her death because I wasn’t performing the compressions properly.
After about 10 minutes, my arms grew sore and tired. But I did not dare ask for help. I couldn’t look weak in front of my peers.
Soon afterward, the upper-level resident called the code, and everyone stopped what they were doing.
Time of death: 11:45 p.m.
I looked around the room as everyone dispersed. Blood was smeared across the floor surrounding the stretcher.
I sat down on a stool in the corner for a moment as the last few people left the room and the lights were dimmed. The room fell silent.
There lay a young woman about my age, dead, with a white sheet covering her body.
I sat there a bit longer in the dark, gathering my thoughts. I couldn’t believe what I had just witnessed: a human being dying right in front of me.
It was at that moment that I realized what it meant to be a doctor.
For me, I grew up a lot that night.
This wasn’t a scene from a TV show. This was real life. Doctors deal with life and death.
That night knocked me off my high horse and brought me back to reality. From then on, sitting around in the call room with my trauma pager wasn’t cool anymore.
It was a privileged responsibility.
Brian Hoeflinger, MD