Estoy bendecida.

What makes a life worth living?
A beating heart and breathing lungs?
A mind that creates?
Human interaction?
Fulfilling a purpose and hope?

Most would probably argue all of the above, with variability in percentages from person to person.

When the whole universe is dark, and silent, filled with pain, and without time. What makes a life worth living?
 I watched him as he struggled to breathe. Without an audible sound his face contorted revealing his distress. He managed a cough, spattering the back of his face mask with blood. I took my knuckles and rubbed against his sternum. There was no arousal from the all encompassing cloud of heaviness and struggle that is his world. I didn't merit acknowledgement from him so let him be. I increased the flow of oxygen being delivered via his face mask; in no way actually helping him, just merely placing a band-aide for the time being. I looked one last time at the boy's small crooked body and longed to see the day Jesus takes him in his arms.

I hadn't understood why? But as I walked away, my heart heavy; I was blessed to be able to witness this boy's bravery and patience in the face of nigh insurmountable handicap and disability. I wasn't the only one who longed to see him in Jesus's arms. The Son of God himself is anxiously awaiting the day as well. And he will see. And he will hear. And he will stand and walk and run. And he will be without pain. And he will smile. And he will be blessed as I have been blessed by him.

Much Love.

Estoy contando los minutos.

The night is drawing to a close and not a single trauma has rolled through those automatic sliding doors with EMERGENCY in red letters written above it. Will the calm last? Only the next 76 minutes will tell.

Very odd for a Friday night/early Saturday morning, but welcome nonetheless. Almost as if karma was making up for last night when I arrived to work to find all three trauma bays freshly filled. Two more traumas rolling in within the hour and the trauma pager signaling two more to soon follow. It had decided to rain yesterday and apparently the people of New York had missed the memo.

The month of nights is moving along. Three weeks down, one and fraction to go. It’s been educational so far. I’ve gotten to put a few tubes in chests and a few catheters in central veins. Need a couple more yet to get the process down pat and be comfortable to do it on my own. But getting past the first couple is the biggest step. Even had the opportunity to put in a chest tube while the patient was being coded. Having someone pumping up and down in an effort to push blood from a patient’s heart throughout it’s body creates a moving target for your tube. I’ll be honest… I didn’t exactly hit the bull’s eye on that, but I’m thankful I at least took the shot. Next time, it’ll be the bull’s eye.

Will plan on heading up to CT once I get off work. It’s a nice thing about being night float; being able to make it to church every weekend. Makes for a rough Sunday night at work, but all in all one can really tell a positive difference.

Much Love.

Estoy viendo por siempre.

World One

 

Last Saturday I met Ben and Ashley Wagenbach in the city. We went up World One and then visited the 9-11 Museum. It was Ashley's idea to go up World One, and I'm glad she suggested it. On a clear day the horizon extends for 45 miles. Wasn't quite "clear" last Saturday, but it was still an impressive view, just a gray one.

 

I hope to return in 50 years, on the 50th Anniversary of the World One Observatory. I want to come back to see what has changed. The price of a ticket compared to 50 years ago. Maybe the whole thing will be digitalized and there will be booths that you can click on a picture and you'll "fly" out from the Observatory and "hoover" over what you wanted to see closer.  Or maybe we'll all have flying vehicles by that time rendering a World One Observatory useless, and it'll be shut down before it even gets to it's 50th birthday. Either way... I wonder what will happen to those wine bottles.

The only picture I got of Ben and Ashley! :/

Looking down on the 9-11 Memorial

Even the Empire State Building looks small from here.

Brooklyn, Manhattan and Williamsburg Bridges over the East River

Slurry Wall. 9-11 Museum.

 

Twisted metal. 9-11 Museum. 

Look for the Silver Lining.

Much Love.

From The Eyes Of An MS3.

The following have been written by and then posted with the permission of the three 3rd year medical students currently completing their week rotation of nights with us.  They were asked to reflect and relate in as few or as many words as needed about their perspective surrounding the critical level 1 trauma we had a few nights ago.
--------------------------------------------------------------------------------------------------------------------------

My name is Lydia Bunker and I'm a third year medical student at NYMC. I'm from the suburbs of Boston and I've always wanted to be a doctor.

Last night, my fellow classmates and I were working with the on-call trauma team when we got the page for a Level 1 motor vehicle accident. Within minutes the ambulance pulled up, the ER doors opened, and the prior calm of the trauma bay was shattered. The tall bulky young man on the stretcher looked to be beyond humanly help, but nevertheless two dozen people sprung into action around him, each with a look of extreme focus and determination to perform his or her role perfectly. Suddenly he regained a pulse and our interventions seemed less futile. There was a chance he could live, and that possibility lifted the feeling of dread I realized had enveloped me.

I wanted so badly to help with the resuscitation, but was afraid of getting in the way of the expert staff who were doing the real work of saving this young man's life. So I hovered on the margins of the crowded room, ready to jump at the first call for assistance. Anything - from doing chest compressions to simply offering a timely piece of tape. What struck me most was the thought of how we must have looked from above. Dizzying motion and cacophonous noise.

Miraculously, the patient stabilized, unknowingly advancing himself to the next step in the algorithm of trauma care. Almost as if forgetting that this young man had been essentially deceased an hour earlier, preparations started being made for the trip up to Interventional Radiology. We left the trauma bay strewn with empty plastic packets and stained gowns. The litterbug police in me thought absentmidedly about picking up a discarded syringe cap on the way out. Such an absurd thought when a life was on the line.

Over the next few hours, the resident and I occasionally left our trauma patient to attend to consultations elsewhere in the hospital. It was hard not to compare cases. A little kid with a bellyache seemed of such minor importance. Yet to him and his father, there was nothing more important that knowing whether he could go home or not. The teenager in critical condition upstairs meant nothing to them. It struck me that in medicine, you really can't think in "relatives". Each person's problem is uniquely important to them and we as physicians are challenged to adjust our delivery of care accordingly.

Later, back upstairs, we huddled around glowing screens in the CT control room, waiting for the next layer of digital information and keeping vigil for our patient. I watched the tired eyes of the attending surgeon as he scrolled through the images, up and down, up and down. I could see him envisioning the upcoming surgery, choreographing a plan of action, weighing benefits and risks.

The students were dismissed before our patient went into surgery, leaving the attending and residents to complete the work they have been primed to do. I drove home as the sun rose, wondering how they had the mental and physical strength to carry on through exhaustion. I hope that someday I'll have the knowledge and stamina to do the same, to stop at nothing for my patients. That's why we work so hard in medical school, why we spend long hours in the hospital, why we practice our skills at every opportunity- so that when the time comes, we will be ready.

--------------------------------------------------------------------------------------------------------------------------

 

My name is Andrea, I am a medical student and this is my first surgery rotation ever. I have dreamt of being a surgeon for a very long time. The adrenaline of the job and the direct impact on patients are two of the reasons I am so attracted to this specialty. Funny enough both of these qualities came into play last night. Last night we attended to a level 1 trauma which is the most serious type of injury that requires immediate medical attention. Our patient came in unconscious and in cardiac arrest. All of a sudden the adrenaline rush that I had been so excited to feel turned into a feeling of nervousness when I quickly realized every move we made could be the patient's last chance to live. The patient's condition waxed and waned throughout the night and as each hour passed the trauma team worked harder and harder to keep him alive. This experience made me realize the immense impact that the medical team has on these emergency situations. I specially realized that the role of the surgeon is not only to cut, but their role is have the knowledge and experience to attend any situation. The most important lesson that I have taken away from last night and from my experience with the trauma team is that the adrenaline and spontaneity of the job do not compare to the satisfaction of being prepared with the knowledge and compassion to take on any situation and go home each day feeling that you did everything in your power to help someone's loved one.

--------------------------------------------------------------------------------------------------------------------------

My name is Nathan Carberry. I am a third year medical student on my second week of my surgical rotation. I came to medical school because I wanted to be a source of healing for people in their most desperate of circumstances. In the years of training and dozens of exams that it takes to finally reach a position of utility in the medical world, I often find myself distanced from this primary directive. However, I feel closer after last night. I found myself as a member of a team for a level one trauma that received a young man who was facing darkness – no breaths, no heartbeats, no thoughts. The setting was deadly serious and the staff as solemn as a funeral, and I was in a terrifying position to help as the patient received compressions, chest tubes, and central lines. I watched as the man regained his own electrical rhythm and soon after vitality to his face. By the end of the long night, the young man had his life again and the parents their son. Very generously, the trauma team also gave me back my direction.
--------------------------------------------------------------------------------------------------------------------------

Much Love.

Estoy tratando con la pérdida.

Moving into November means moving onto the next rotation. Had a nice call today to finish out my month on Vascular.  I switch to Night Float for November and therefore know that I should stay up super late tonight and then sleep to 4pm tomorrow.  But I so want to just go to sleep... and then still sleep till 4pm tomorrow!!

Together with our Vascular Chief for this past month. Half way through the month the three of us were given an extra task.  The task to train one of our colleagues returning from medical leave. With one intern out on medical leave and one second year out on paternity leave the entire gen surg residency had been stretched even thinner than usual. So of the usual teams the three of us were deemed the strongest option to be able to handle the undertaking of this task. It's the end of the month now, did we succeed? did we fail? only time will tell.  But we surely did try!

   This is Aditya (Adi). He has been my intern these past two months (ACS for September and Vascular for October). Last year I was his intern. We joke that should I become an intern again next year, then the two of us will never actually finish residency. We'll just keep taking turns being each other's senior.  But really, you see your team members for 14-16 hours a day... every day, all day! It's a huge blessing to enjoy your team members. By the end of two months working with Adi we'd made so many inside jokes we could laugh at just about anything. Yet be serious too when needed.  And there were more than a few times over the past two months when, as Adi puts it, our patients were "discharged to Heaven." 

In honor of my treasures.

 

Much Love.