Chapter 18
CHAPTER EIGHTEEN
ELLIE
Working the ER will break your heart. The words from my old charge nurse in Boston are ringing true in my head on this shitty Monday.
One of my patients died this evening. He was only thirty-seven.
I want to forget him right now so I can focus on my current patient, but I already know she just has the flu and it’s not taking up enough mental capacity to banish the memories of that damn flatline tone.
It’s not that we got particularly close; he wasn’t here very long.
But he was in a car accident and those cases are always particularly poignant for me.
The dull tone of a flatline is not all that different from that ringing noise you get in your ears.
It’s hard to describe and yet everyone knows exactly what it sounds like.
Sometimes I feel like I hear phantom flatlines when I’m not at work.
They don’t happen frequently, but this is the biggest hospital with the best emergency department in Minnesota, and just based on the sheer quantity of patients, we see a lot of death.
And like everything else in the world, flatlines are really nothing like the movies. Hollywood always depicts them as quite dramatic, obviously—that terrifying tone coming out of nowhere, followed by doctors desperately trying to shock the flatlined patient back to life.
The one thing they do get right? The chaos. That’s totally real. It’s organized and efficient, but chaos nonetheless. And sometimes we are terrified to hear that tone.
But that’s because it usually means we’re too late.
Flatlines don’t just come out of nowhere.
Hearts don’t just stop. They struggle and they fight, the electrical impulses firing away until the very end.
It’s during that struggle and fight that sometimes we use a defibrillator to “reboot” the heartbeat and try to get it back to normal.
But you can’t reboot something that’s gone.
So when you do see that final flatline? There is no fight left. There’s nothing to shock to life, nothing to fix. It’s irreversible.
And it’s haunting.
We’re desensitized for the most part. But sometimes that noise just stays with you. Follows you around all day. Memories of the patient and their fight replay in your head like some traumatizing movie reel.
My therapist back in Boston wasn’t sure going into emergency medicine was the best path for me. And honestly? She had good reason to think that.
She was worried it might keep my trauma too fresh, being in that environment—like a scab you keep picking at and won’t let heal. She smartly encouraged me to do my research and talk to other nurses.
And everyone said the same thing. Warned, really. When you get into this field, it is going to take a toll on your mental health.
They said it’s traumatizing and often thankless. It’s chaotic and impossible to feel caught up. That it’s draining and easily turns that desire to help people into a disdain for the healthcare system. They said you’re likely to burn out—most people do.
And with all those things listed out? I can admit I was intimidated. Who wouldn’t be? It does sound rough. But some things they shared as hardships of the job I only saw as reasons why it was perfect for me.
Because I’d been an ER patient and had lost a lot. So I knew what I wanted out of my job. What I needed.
First? The lack of downtime. I’ve talked about this before and I’ll continue to preach it: having a job that doesn’t allow for a wandering mind is really, really great for someone who doesn’t want to get lost in their thoughts.
Maybe someday this will change, but when I was picking a specialty?
And even now? I crave the utter focus my job requires.
The days I go to work are often my best mental health days, despite the trauma that so regularly comes through those doors.
Sure, the reminder of my own can hit me like a wall, but just as quickly I’m swept away in the task of it all.
I’m just working and helping and passing time faster than anything I’ve ever experienced.
For the most part, I don’t even think much about my work day once I’m home.
Which leads me to the next thing on the list.
Emergency room patients are in and out. And you know what that means?
No long-term relationships. This one is a major downside for most people getting into nursing.
You hear the stories of the angel nurses that patients connect with and how they become almost like family.
How they kept in touch over the years because of how much time they spent together in the hospital.
And don’t get me wrong, I love those stories.
I do. I fell in love with nursing because of those stories.
But after the accident, the idea of forming meaningful, lasting relationships with patients scared the shit out of me.
I didn’t even want new friends or a boyfriend for nearly two years after my mom died.
So the idea of having a constant influx of people to get attached to?
No, thank you. Getting attached is all fine and good until your patient dies.
And then not only is your patient dead (shitty), but you’re way more heartbroken because you knew them and now they are gone (ultra, ultra shitty).
I’m not going to say it’s a matter of quantity over quality, because that’s a gross oversimplification (and probably makes it sound like I don’t deeply care about helping my patients), but you get the picture.
I have to care without getting attached.
Because in the ER, you just don’t have the time. And that works in my favor.
The next two things were just…things I couldn’t get out of my head. Things that really stuck with me since my day in the ER.
When I was a patient there, a lot of it was a blur. Not really in a metaphorical way either. I was in and out of consciousness and often I’d open my eyes to bright, unfocused light. The noise was not loud, but it was jarring all the same. I was lost and confused. I was hurting. And I was scared.
I must have said it out loud at some point, because despite the blur, I have a very clear memory of one of those aforementioned angel nurses.
She said it was okay to be scared because she wasn’t.
She held my hand a lot and talked me through what was happening.
When she found out I was in school to be a nurse she got more detailed in her descriptions of various procedures—more technical.
I still remember her voice and how calm she was.
How she made me less scared just by the simple fact that she wasn’t.
There was something so comforting about that.
I so badly wanted to have that type of impact on my patients. To bring peace to an often chaotic place. Safety to somewhere people feel scared. I can do that, I remember thinking. And I hope I do. It’s one of the main reasons I love my job and why I continue to do it.
Sometimes that’s the main thing the doctor needs my help with, keeping the patient calm—getting them to focus on something as simple as breathing.
And I was doing that today, using my normal script and holding his hand, when I noticed his nails were messily painted bright purple.
The edges were uneven and some smudges of the polish were on his fingers. I asked him where he got his manicure.
“My five-year-old,” he rasped. “Little girl.”
I should’ve seen that coming—the adorably sloppy job had tiny human written all over it—but that sentiment left me reeling.
I knew from the doctor and my own read on things that his chest injuries were causing a rapid decline.
He wasn’t going to make it. He wasn’t going to see his daughter again. And she wasn’t going to see him.
It’s a shitty club: the dead parent club. I wish so badly that little girl didn’t have to join it. I think it’ll be a while before I can get him—and her—out of my head.
And that brings me to the main reason I wanted this job. The reason I’ve been stuck on this path ever since the worst day of my life.
I would do anything to keep someone from being in my shoes.
I will keep going and going and going so that maybe, maybe I can save someone from having to live without their mom or dad.
I couldn’t be that person for that little girl today, but I’ll never stop trying.