First Day Jitters

Today I started a new job in the exciting field of emergency medicine!  As I sat in orientation listening to lectures on everything from HR to ambulance checks to uniforms, my thoughts drifted back to other big “first days.”

I have always loved school, and I still get those first day jitters, think about all the exciting things I am going to learn and all the friends I am going to make! Science class was my favorite, and I was always nervous about getting a good lab partner, since I seemed to keep getting stuck with the squeamish kid or the lazy kid or the bossy (ok, bossier than me) kid.

My first day volunteering in a local emergency department (ED) was also slightly terrifying, because I would be seeing people in pain, scared, and vulnerable. I was used to being a patient up on a cozy inpatient pediatric ward, but the ED is a much more intense place.  Our trainer, Gabe, was hardcore, too.  He had seen action in Afghanistan and was a very confident, outgoing guy.  He seemed to know everyone, including the doctors, which is rare for a mere volunteer.  He spent the next four hours giving us the tour while keeping up a running dialogue of how things worked, who did what, and where to find the action.  He had real insight into how the different personalities fit (or clashed) in a busy ED, and how best to ingratiate ourselves to the staff.

* Graphic trauma description ahead *

I saw my first (and to-date, worst) trauma on my second solo shift in the ED.  It was a hit-and-run bicycle accident (common in Cambridge & Boston), where the bike messenger was in BAD shape- she had been flown in by med-flight.  Our hospital doesn’t usually get”fresh” traumas, but since the hospital is so specialized, we get the “zebras” (cases requiring special complicated treatment).  We got her because her hand was basically severed at the wrist, with just a flap of skin keeping things together.  Luckily, this girl had been wearing a helmet–it saved her life, but she had a huge gash down her thigh, as well.

I knew that this would be my test–would I faint? Vomit? As the room filled with people, I stood there staring at this girl’s mangled arm, at the blood and the protruding bones, at her bruised body, and at the people trying to fix her.  The sight certainly wasn’t attractive, I thought about getting sick, like I was considering my options, and I decided that I was more interested in what the doctors were doing than in passing out or losing my lunch. I stepped around the med student (a guy younger than myself) who was obviously having a harder time with the same dilemma, and a few of the docs stepped to one side for me to get a better look for a few seconds.

That was the day I think I first truly realized that I could be a doctor.

(Also – always wear a bike helmet!)

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