Trauma Bay One

It was a warm and sunny late spring day. A comfortable 73 degrees, the birds were chirping their harmonious chorus while the flowers blossomed in vibrant yellows and violets. Yet today, of all days, I was sitting inside at a desk typing away at my medical scribe laptop in the windowless emergency department. I took a few moments to daydream about the nice weather I was missing out on while being stuck at the hospital. I briefly hoped that I might get released early today, but then I remembered that this was the emergency department and that never happens.

Like many medical scribes, I aspire to become a doctor one day. To help prepare me for the field, I trained to become a scribe in order to gain valuable up-close clinical exposure. It was undoubtedly a meaningful experience, although some days it was difficult to be as appreciative of this opportunity as I should have.

I was steadily chipping away at the medical charts for the new patients the ER physician and I had seen that day when suddenly the overhead announcement system bellowed: trauma activation, trauma bay one, five minutes out.

The ER physician called out to the trauma nurse. “What’s this trauma coming in?”

“Young child with a right foot amputation,” the nurse replied. “The patient is still conscious and alert out in the field, but it sounds like there was significant blood loss. Paramedics are bringing him in by ambulance.”

My heart lunged into my throat. A young child with a foot amputation?! I had yet to see an injury so severe. Yet here I was, the one responsible for documenting the course of care when they arrived. I was petrified.

The physician hopped up from his seat. “Let’s go meet them,” he called out to me as he began briskly walking over to the trauma bay. He seemed so relaxed. His calm demeanor was the perfect antithesis to my brewing anxiety.

I stood up and disconnected my laptop from its charger, my fingers helplessly trembling. My nerves were rattled, and I could not help it. I knew it was going to be loud and chaotic in that trauma room. People would be running across the room all shouting at once. I was worried that I would not be able to hear a thing in there. Then what good would I be as a scribe? But there was no time for such worries right now, I tried to tell myself. The ambulance would be here soon, and then all hell would break loose through those trauma doors. I quickly opened a new medical chart note and rushed after my physician over to trauma bay one.

The child was screaming as the paramedics powered through the doors and wheeled him into the trauma bay. Bright red blood was spattered across his pant legs and soaked the white towels that the paramedics had used to cover his right foot. Tears streamed down the child’s face as his cries filled the room. The paramedic team carefully transferred the child from their gurney to the trauma bed. The lead paramedic turned to the physician and began reciting the history of the incident. I found a vantage point from where I could hear the story and furiously typed away at my laptop. The child’s cries seemed to get louder, and this was soon joined by the shouts of the nurses and medical assistants as they were readying supplies and starting his intravenous line.  The chorus seemed to grow louder, to the point where I could no longer hear the clicking sound of the computer keys as I typed. I could barely even hear my own thoughts.

As the lead paramedic finished giving history, the physician immediately turned to his flurrying team and began giving orders. “Let’s get that IV started. Give two micrograms of fentanyl. Draw up some trauma labs. Type and screen him in case he needs a transfusion. I need x-ray here now!”

I stepped back and surveyed the chaos that was unfolding before my eyes. Nurses, phlebotomists, medical assistants, and x-ray technologists were scrambling back and forth across the crowded trauma room. The atmosphere was a cacophonous symphony of shouting, screaming, beeping, and buzzing. I became overwhelmed with the sheer volume of visual, auditory, and olfactory stimuli that was assaulting my nervous system. In that moment, I wondered whether I would actually be able to handle this life and questioned whether or not medicine was right for me.

I peered over to the physician. He was commencing with his thorough head-to-toe physical examination of the patient. He wore a calm yet focused expression. His ears were plugged into his stethoscope as he carefully auscultated the patient’s chest. In the midst of the chaos and movement that flurried around him, he was serene. His calmness projected a sense of unbreakable confidence, focus, and determination. Despite the chaos that unfolded around him, he knew that he was in control of the situation. This was his patient, in his trauma room. Whatever was going to happen, he was going to know about it. Whatever was going to be done, he was going to be the one who ordered it. If anything during the course of care went awry, people would look to him for guidance. And he accepted this responsibility because he was the attending physician. This was what he trained and sacrificed nearly half of his life for. And after all that training and sacrifice, his calm and collected sense of confidence in this moment was signaling to everyone in the trauma room that he was ready for this challenge.

As I stood from the corner of the trauma bay and watched the physician work to save the patient, I was overcome with excitement and awe. The thought of being in his shoes invigorated me. To be the one who people turned to when the going got rough, to be the one in charge of caring for someone during the worst day of their life was who I wanted to be. At that moment, all doubt about becoming a physician was banished from my mind. The chaos in the trauma bay was as loud as ever, but I was no longer afraid. Watching the physician wield his mastery of medicine reminded me why I wanted to become a doctor in the first place – to help get people through their desperate times of need and to serve as a leader of a group of people collectively dedicated to this noble cause. Medicine; the field that discovered such modern marvels as anesthesia, antibiotics, and x-ray machines; the field that had made possible organ transplants and the sequencing of the entire human genome; was now going to be responsible for saving this young boy’s life. No other profession out there is as powerful, or as humbling, as the remarkable field of medicine. And I was determined to dedicate my life to this noble profession.

As the physician and I departed from the trauma bay upon finishing our work, I glanced at him with a profound sense of admiration for what he had helped me learn in that room. As if sensing my gaze, he asked, “How are you doing, do you need a break?”

I had forgotten about my griping earlier. After this experience I was as energized as ever. There was no place else I would rather be. Full of new vitality and a sense of profound purpose, I replied enthusiastically, “Not at all.”

“Great,” he smiled, “Let’s go see another patient.”