Last evening, there was a bombing at a bank in the town of Woodburn, Oregon. I'm still trying to make sense of that fact, let alone that the small town's police chief was on the O.R. table before me.
I won't go into detail, because every patient and their family has the right to privacy. I've never actively sought to break that solid creed. When I saw him, he'd already lost a leg and the other one was very badly damaged. When I took a break after five hours of surgery, I went with one of surgeons to meet the family and discuss our progress. The emotion in that room, from dozens of family and friends, was an entity unto itself. Vocal. Impassioned. Present.
What I'm writing may seem graphic, probably unorganized, definitely to be respected as the family and friends of those effected by this incident are to be considered first and foremost.
But I respect everyone too much not to write about my experience; and perhaps I just need to let this one out a little because something happened to me during this case that hasn't happened during the thousands of other cases I've scrubbed in my past nine years.
Whenever I enter a trauma room (an operating room that's prepared with specialty instruments and machinery designed specifically for acute trauma) I immediately take in the activities. It's not like television. It's not like anything else really. I'll see people talking on the phone, wide eyes, a lot of clear tubing with various colored fluid passing through them, some laughter at times, random styles of music might be playing in the background, pagers beeping.
It's a sensory whiplash with a peppermint shock. It's a first kiss feeling. A cheyne stoke on a cigarette. It's a feeling you get when you know what's coming isn't just something that hasn't really happened before, but it has and you know to start expecting anything to come next.
What I've learned in over twenty years of direct patient care is that this anticipation of anything happens all the time. A lot of "front-liners" might be ex-military, trained or exposed to combat wounds that American civilian facilities aren't accustomed to see.
I've seen some bad wounds, perpetrated for various reasons. Self-inflicted gunshot wounds, homicidal stabbings, pipebomb and fireworks accidents, deglovings from car crashes and even the mutilations that result from vengeful gang violence. All of these categories of injuries rouse the senses that I described above.
They fill you with a n urgency that's tempered from doing a lot of them, but allowed to show just enough to express confidence and comfort in the unbiased messiness of it all.
What happened to me tonight was new: It wasn't there.
I was confident to scrub the case. That hadn't changed.
My understanding of the needs and procedures were present. That hadn't changed.
I know these surgeons. I trust them. They're First Class. That hadn't changed.
I treat every patient like they have a family member hanging on every move I make to do everything I can to help. That hadn't changed.
But I had changed. I didn't feel anything tonight.
It's gone. That spark that makes my direct involvement in trauma feel like a horse's kick to the heart -- gone. And it probably left long ago, but like a gunshot fired from miles away, the bullet hit me long before I ever heard the discharge. Tonight I realized that sensation really had left me, and now I'm left to wonder why.
This diary isn't exactly about the tragedy that took place in Woodburn; but it does have to do with how people react to trauma.
It's not exactly about terrorism or it perpetuation on civilians; but it cannot exclude that setting off a bomb in a bank is just nothing short of wicked.
I'm thinking about all of those family members, the dozens of them; and the dozens of local, city and state police officers that came here to the hospital tonight to show their support for the family and victims of this cowardly act.
I'm thinking of you, reading this, wondering if I'm alright -- and I am. I am because I know that tomorrow this could happen again and it might not. But I know that when it does happen, I'll meet that need (like I have for decades now) but something will have changed in me: I won't feel as present as I used to feel.
Think well of the victims and families tonight. Thank the local, city and State police and emergency medical professionals that offer their services around the clock. Be thankful, and cherish what you have.