One is too much

Someone asked me one time how I could be a doctor and deal with all the death around me. How was it possible to assume so much damned responsibility and still be able to sleep at night, knowing that my patients could die, and often do. I've already had 4 patients die under my care in the last 7 months. Med school was actually worse. During one month on vascular surgery, we racked up 4 mortalities.

People think that it's this giant burden to bear and that it's such a difficult task. Well, it's not that bad. Really. And do you know why? It's quite simple, really. One is too much. After one, it can't hurt you as much, it can't haunt you as much. It rolls off more easily, because you're tapped. It empties you, and there's nothing left there.

My priest was saying in his homily a while back that his first day of work, he tried to give of himself and was emotionally exhausted, and he had given all of himself, and all that was left was to give God. That's what medicine is like. You give all of yourself to that first patient that crumps. You give your heart and soul, and you die a little when he dies. And after that, you've nothing left to give of yourself.

And you might think that's cold and callous, but you've got other patients to treat, other people to care for. You can't let one person drag you down because there are 15 more where he came from. So after that first one, it gets much easier to let go.

And if you think me heartless, I can tell you this: the first patient of mine that died, in my 3rd year of medical school, I can recreate her history and physical exam from memory. If I sat down for 10 minutes, I could probably come up with her medication list as well.