A Shield About Me

"As long as there is a beat and a breath, do all you can!”

That’s what the family told me. But I knew from the moment that I laid eyes on the patient that they wouldn’t make it through the night. I knew we would code and code and code and that eventually I would have to call it. I knew we would reach a point when there would be no beat, no breath. And in the end we did.

I don’t know that doing all we can is the best thing to do. In the last moments of life I do not want someone pounding on my chest, feeling my ribs break under the force of their arms, having air forced into my lungs, feeling hands in my groin searching for a pulse, having a central line stabbed into my neck, being repeatedly shocked by the defibrillator. I don’t know what the patient felt or knew, but I hope not much.

Doing all we can sometimes means doing harm. We worked so very hard and in the end it profited nothing. I eventually called it. The patient was dead. Had the patient really even been alive since the moment I saw them?

I think I’ve always wanted to be the go to person, the person called to come “save the day” in intense situations. I wanted to be responsible. Now, being in that position, I realize the complete weight of that responsibility; I did not previously understand the stress of that burden. This past week I worked a couple shifts and found the weight of that responsibility almost unbearable. Lives depended on my thinking, my aptitude, my knowledge, my choices. I love what I do, I find joy in my work and in my practice, but it is also a burden. Sometimes the joy outweighs the burden and sometimes it does not.

Sometimes I make inappropriate jokes during extremely stressful moments. I emotionally take myself out of the situation and converse with others in the room about the weather, the smell of vomit, the tattoos found on the patient, anything else. Joking helps. We all laugh.

But sometimes I’m already emotionally invested, there are no jokes. I feel the weight of the world on my shoulders, I crawl deep within myself, I become short with the nurses, I become the burden I feel. In moments like those I often feel all alone. Ultimately I’m the one responsible and there is no one to help me.

I don’t know why, but when I find myself in extremely critical situations at night, I usually find myself partnered with the same nurse. She’s been a nurse a long time. She does her best to help me in whatever situation we find ourselves in. Recently, we were once again in a critical situation, the patient wasn’t fairing well. I was getting frustrated. I was trying to put a central line in and I was having trouble, I couldn’t find the vein, the patient needed it quick. The room was quiet. And there she stood, this nurse, assisting me. And then, during the midst of that extreme stress, she began to pray. It was a short prayer, my eyes never left the site I was working on, but my ears were on her words and my heart soon followed.

The truth is I am the one responsible. But the greater truth is that there is someone to help me.

A dear friend recently sent me a CD. I have listened to those songs over and over lately. As I walked into work tonight, with the weight of last night still dissipating from my mind I found the words to one song filling my soul.

“Thou, O Lord, art a shield about me
You're my glory
You're the lifter of my head
Thou, O Lord, art a shield about me
You're my glory
You're the lifter of my head

Hallelujah
Hallelujah
Hallelujah
You're the lifter of my head

So, tonight I will say to myself, “As long as you have a beat and a breath, do all you can!” And I will, because I’m not alone, never have been.