My Ecology

You died. You bloody died! You weren’t supposed to die. You were supposed to be the part of the story where I learn the true magic of modern medicine, the Saving Lives dream come true. But you died.

My history of you begins with the bat phone. It’s really called that. Loud important noises go off, the two way radio gets picked up, the story begins. An electronically transmitted ECG appears on the screen. It’s bad. It’s real bad. My registrar tells me to go to the resus bay and I busy myself setting up stuff to put a line in and get blood. Needles, tubes, alcohol wipes. And then you’re there on a stretcher, eyes wide open, scared. You’re barely moving. You’re talking two words at a time. People are everywhere, fussing with breathing gear, setting up for an ECG, attaching you to monitors. The boss is shouting orders. I shout back that I’ll get a line in. My reg leans in and says “are you sure can do it fast?”. I nod yes. It’s automatic. Immediately I doubt myself, I’ve only tried one line this large before and it was such a horrible painful failure that I never tried again. But this time it’s different. The line goes in immediately.

We push in fluids, the cardiology team arrives, time for you to go upstairs. Upstairs. The magic life saving place that is the cath lab, where truly broken hearts get fixed and where you’re supposed to live. You’re only young. Your wife and daughter appear as you’re being wheeled away. The boss stops the bed moving for a minute so they can have a moment. An eternal moment. I watch from a distance as your wife sinks into a chair and your teenage daughter stands there blankly. And then you’re wheeled away. Wow, I think. Wow. To be a cardiologist must be so amazing, because they’re going to fix that.

We go back to our other patients. Five minutes later the sound of emergency pagers ring out, reaching a collective crescendo. The team leader nurse is already halfway out the door with the portable defibrillator. She shouts at the medical student, the only one free to push the cart. He’s only just started on clinical rotations None of us doctors can help, we’re too busy with the other patients. I watch him obediently follow her up stairs.

We go back to work. Later the team leader appears. “He arrested. He’s tubed now. They’re pushing on with the angio”. Everyone agrees to find out what happened in the morning, it’s time to go home, now past midnight.

I’m at work today. I have a few patients I’m sorting out, mainly elderly people with elderly person problems. I see the cardiology registrar. I ask him. The registrar shrugs and says “oh that guy died”, and walks off.

You weren’t supposed to die.

I go back to work. The wind is out of my sails. For a minute a small voice tells me I want to cry. Another tells me it’s not my journey. Another tells me to get back to work which sounds sensible so I do. Another says nothing and just observes.

“You’ve got to learn to be more lazy”. I look up, and an intern is standing there, handing me a coffee. It’s late. It’s nearly time to go home. “you’ve seen so many patients” she says, “way too many!”

She’s right in a way. I’m not getting out on time. There’s a lot of paperwork left to do but I don’t really mind. I used to mind. I stay back and finish it. I lament my lack of thoroughness for seeing so many. I call consultants to get the patients admitted and give half baked stories but it’s late and they just want to sleep so they accept them.

I get my handbag and walk back to my car. Driving home I notice the other cars on the highway, some big, some small. Lights passing through the night.

You weren’t supposed to die.

The Scream

Years ago I went to an Edvard Munch exhibition, the contents of which spanned his life. I will never forget the room dedicated to the development of The Scream, it’s a picture which repeated itself throughout his life, but it was one of the first sketches of it, made when he was young that really haunted me.

The original drawing showed a child standing in front of a bed, hands to face, mouth opened in horror and terror in its eyes. On the bed behind the child laid their mother who had just died. Edvard was only five years old when he watched his mother die of tuberculosis in 1868 That drawing haunts me to this day, he drew it over and over again.

The famous 1898 picture has taken the fear and the horror from that child, and transferred it to another place – blood red sky, a bridge, but the emotion is the same. The saddest part, when you think about it, is that terrifying childhood thing, to, as a five year old watch your mother die, and quite horribly, was carried with him, was transplanted to wherever he was. It’s a painting that has so many layers if meaning to it but this one speaks to me the most. That monsters-under-the-bed fear of something terrible happening to your parents, and that fear coming through.

Now why you’d want that hanging on the wall is beyond me!

To end on a happy note, some of Munch’s last works were of green grass and blue skies with white fluffy clouds. His style completely changed in terms of content, suggesting that he found some peace. I so hope he did. That worst-fears-realised painting might have gone for over 100 million dollars but I like to think that Munch would have given all of his talent, fame, and money that he made, to have never had to paint that painting.