Emergency Room

Emerging from the emergency room, gasping to find my breath, I weep.

I finished my last shift in that hell-hole, and I thought I would cry tears of joy, but instead I am crying tears of raw emotional release.
My patients called me an angel, but many of them were also angels to me- holding my spirit buoyantly with their sparkling eyes, a much-needed balance to my co-workers who seemed mostly dead inside.
Crushed inside the machine
Their eyes see only the screen
Their skin knows no fresh air or sunlight
As they toil day and night
In a crowded, chaotic space filled with alarms
Long ago, they replaced their charms
With rigid motions, mechanical minds
Without windows, they don’t notice the passage of time
When did they become so cold and bitter?
It must have been little by little
The fire in their hearts was starved of oxygen, their spirits wore away
I hope I keep my heartspirit intact, at the end of the day
Flashback to a line of gurneys in the ambulance bay
My attending grilling me, I didn’t know what to say
Broken bones and chronic pain
STAT CT to look for a bleed in the brain
Patients sustained on turkey sandwiches and diet ginger-ale
We wait on them, they wait for us, but we are all stuck in this jail
Trapped in a health care system which is systematically inhumane
No wonder so many of us don’t feel quite sane
My vision is blurred by tears
I’ve finished one more day in the middle of many hard years
Of sacrificing my life, enduring unfathomable strife
Just to help others survive another night
I want to get off this roller coaster, but I’m strapped in
Though I am sick to my stomach and deafened by the din
I return to my breath, breathe in new air
I have the rest of my life to move on towards
Tomorrow night, I’ll be back in the wards
With renewed gratitude, I leave this emergency beast
I walk past patients waiting to suckle the mechanical teat
Finally allowing room for my own emergency
My meltdown of tears isn’t enough to drown out the blaze
Which burnt me out long before today
I struggle to justify
Why I put myself in situations that make me cry

Pain

Pain and addiction.

I walk the line between giving too much and giving too little.

Rarely do I get it right.

Rarely do I feel right with myself when I prescribe opioids.

Knowing what lies on the other side of pain relief, knowing the train wreck waiting at the end of the line, knowing the lifelong prison sentence that opioid dependence brings- held hostage in our own skin, til death do us part.

Too many loved ones have died too young from overdosing.

How can I justify prescribing a substance that could suddenly and unapologetically kill someone I’ve never met, somebody’s beloved son or daughter, a curious teen who wanted to feel comfortable in their changing body, experimenting at a party, sampling the medicine cabinet

I want to feel comfortable too.

You complain of pain that you’ve had for years and expect me to fix in an instant.

You say there is a national opioid epidemic, but that you are not a part of the problem.

You say that tylenol and ibuprofen don’t work on you. You say that you need at least Percocet.

You say that other people have been prescribed more for lesser reasons.

You become bitterly enraged if I hesitate, and sickly saccharine if I yield to your request.

You shout that I wasted your time if you don’t get what you want. It kills my spirit to prescribe you opioids, because opioids are, in my humble opinion, the worst medicine- the most risk for the least benefit. With opioids, there is no healing, only the creation of an unnecessary problem without a solution.

It makes me want to leave medicine when I prescribe the medicine you beg for. I’m not practicing medicine for my health, so if I’m not ultimately benefitting your health, then what the hell am I here for.

Can’t you feel my pain? I’m so damn uncomfortable in this drug-dealer role.

If we reserved opioid use for more select scenarios, like only metastatic cancer or the immediate post-operative period, perhaps opioid dependence would be prevented for many who have yet to be born.

However, there are more drug profits to make and more blood to spill before change will come.

The whole scene makes me ill.

If I wanted to deal drugs, I wouldn’t have put myself through the brutality of medical school and residency. I could’ve just dropped out of high school and saved myself a lot of hassle. That might sound cold, but my pain ignites my fire. You didn’t ask about my pain.

I don’t want to be part of this system because I feel like I’m doing more harm than good.

I’m trying to do right in a world of wrong.

I swallow my words until they explode in a song.

Nobody hears my melody because I work all day long.

Sing sweet nightingale.