A third-year medical student reflects on a life-changing emotional experience
Dreams and reality are often very different things. As a medical student I imagined myself one day taking on the role of a gallant knight, a protector and safekeeper of the sacred flame of life, creating miracles and wonderfully healing the sick. I wanted to make a difference and save lives. A road accident during the summer holidays gave me a chance to live my dream - but it was very different from what I had imagined. This piece reflects on my experience, and on how a brush with real medicine has changed me as a third-year medical student at Monash University.
The smashed machine was the first sight I encountered. A once fast, shiny road-bike now lay on the ground, a metal carcass. I remember running towards it, scared. Next to it a body lay still.
I had seen dead bodies before; cadavers allow us to release anatomical knowledge with the stroke of a blade; they are the ultimate learning tools. But what confronted me was no practical class - this was very real. I looked at the woman lying there. She was young, about my own age of 20, still with P-plates on her bike. It could have been one of my friends lying there. She was dressed up, perhaps coming home from a club somewhere, with makeup and nail polish delicately applied - real human qualities that gave a glimpse into a life that, only minutes earlier, was full. Draped over the top of a young human was viciously snapped; blood and vomitus overflowed from her throat onto her chest; her arm was destroyed. I knelt down beside her.
It was as if I was looking through her. I looked into her eyes but, quite simply, no one was there. Despite the horror of the scene, she looked almost peaceful. Was she just unconscious? Could there be a flicker of life still inside her? Was this my chance to save a life, to make a difference? What happened next was bizarre. I became machine-like, visualising a giant first-aid flowchart in my mind's eye, and began to apply my medical knowledge. Yet again the theory did not match the reality. My only previous attempt at resuscitation had been on a mannequin with a plastic torso and head. This woman had real lungs and a real heart. I turned her on her side and tried to unblock her airway; I had no gloves. Using a mouth-to-mouth protective device that I carry on my keyring, i tried to shield my hands as I attempted to scoop blood and vomitus out of her mouth. I then tried to give her air: "5 breaths in 10 seconds, and watch the chest rise", my training had taught me. But her chest did not rise. AT first I got angry and blamed it on the device I was using, but then I realised her entire airway was obstructed. I searched for a carotid and radial pulse but found neither - the beat of life had stopped. I tried cardiopulmonary resuscitation but she wasn't responding - it wasn't supposed to be like this. Yet I continued until I felt a gentle tap on my left shoulder. It was one of the ambulance officers - I had missed their dramatic arrival, hearing my own thoughts and deaf to everything else. Never before had my mind been so clear or sharp. My adrenalin level was so high that it took tactile stimulation to reawaken me to my surroundings - a feeling I still never forget.
Despite efforts by the ambulance officers, the girl was pronounced dead at the scene.
It was in the day that followed, spending time with my general practitioner, that I began to learn a little about what being a doctor really means. I came to him upset that someone had died, upset at how horrific it was, upset that I had failed, upset that I had done something that may have exposed me to to HIV, hepatitis B or hepatitis C infection, even upset that the damn thing was upsetting me! He sat and listened. Being able to speak to someone who had witnessed similar trauma was amazingly comforting. He told me that the three hardest things to cope with in medicine are death itself, the death of someone young, and the death of someone under your care. I had copped all three "right between the eyes", at a time when I hadn't the experience or the training to know how to respond or feel.
My GP had no magic pills or portions to rid me of the churning inside me. Nor did he need them - all I wanted was for him to understand what I was feeling. I was given an insight into what caring for someone really means. He reassured me that people don't expect doctors to be miracle workers - all a family really wants in this type of situation is for a doctor to "be there and to care". My GP suggested that I attend the funeral service if I felt comfortable doing so. He believed it would give me a sense of closure and that it would help me to be around others with similar feelings. I sat with him in his office after all his patients had gone home, looking through the newspapers for the funeral details.
I sat through the service and listened to the account of a life I knew nothing about. I looked around at the web of friends and family she had interwoven. I was now a part of that web - she had touched me too. At the conclusion I introduced myself to her father, and told him that his daughter did not die alone, that I was there caring for her. I told him that the last few days had taught me more about caring for people, and about being a doctor, than I had learned in all my days at medical school. I told him that I was there for him and his family. With that, the tall, lanky man hugged me tightly, crying and thanking me for being there, for stopping and bothering to care. It was devastatingly sad, yet enormously relieving, and I was proud. He wanted to care for me and to share his feelings with me, something I had not expected. The simple knowledge that their daughter did not die alone was comforting to the family. They knew that if there had been a chance for her, I was there to give her that chance.
I am starting to understand what being a doctor is about. To really care for someone connects people in such a wonderful way that it can even make death seem a little less scary. Sometimes just being there can make all the difference.
