plot points in retrospect

There is some truth to this observation:

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We were reminded of this last weekend as we commemorated the lives that were lost as a result of the terrorist attacks of 9/11. I was at work that day so it was hard to keep up with events as they unfolded and reality set in. You probably remember exactly where you were and what you were doing that day, too.

The same is true for many of us when the space shuttle, Challenger, exploded. I was in the drugstore, at the checkout when I heard the news. When we learned that President John F. Kennedy had been shot, I was sitting in 9^th grade algebra class.

Some memories stay with us because they are tragic, some because they are inspiring, or funny, or scary. Some moments in time stay with us for reasons we may not understand while others are lost forever. One hectic day blends into another until whole blocks of time fade from memory. All we know of our past are the moments we can recall.

A lifetime in medicine is no different. The years we dedicate to patient care—the unending procession of patients, the emergency admissions, and daily hospital rounds—leave us little time for reflection. We don’t purposefully commit each day’s events to memory. Nevertheless, some moments survive as vivid images that flash back to us uninvited years later, each one a glimpse back in time, back into the story of our lives.

Here are a few moments in medical practice that are forever chiseled into my psyche:

•  A gentleman presented to the office with chest pain. His wife was seated next to him in the examination room as I placed my stethoscope on his chest. Suddenly, as I listened, his heart simply stopped beating. He slumped to the floor as his wife looked on. CPR failed to revive him. His story ended that day, while his wife’s story changed forever.

• A “Code Blue” (cardiac arrest) summoned us to Labor and Delivery where a young woman had hemorrhaged following the delivery of a healthy baby. Her story ended there while, waiting in the visitors’ lounge, her husband poured himself another cup of coffee in joyful anticipation of the birth of their first child.

• A patient was admitted through the emergency room for what was described as an unsuccessful suicide attempt. He thought he’d ingested rat poison from an unlabeled bottle in his garage. Instead, it turned out he’d actually swallowed sulfuric acid. Rat poison ingestion is treatable. Sulfuric acid ingestion is not. He was placed in a medically induced coma as his mouth, throat, and esophagus disintegrated. Life support measures gave friends and family just enough time to say goodbye before the doctors pulled the plug. His depression came to an agonizing end that day, while theirs was just beginning.

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Looking back, I don’t remember how any of those days started for me. I forget what happened later on. But I do remember the look on his wife’s face when that first patient slumped to the floor. I remember watching the young woman’s husband cradle his newborn baby in his arms as the doctor explained what had happened to his wife. And I remember keeping the suicidal patient alive, if unresponsive, while his family confronted the unthinkable tragedy that, in fact, ended his life.

Oh, I could go on.

If life is a story worth telling, these are the plot points that change the story arc. 

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They have the power to turn comedy into tragedy, reality into mystery and hope into despair. 

Where do these memories hide, and why do they return?

Do long-forgotten memories ever intrude upon your thoughts? What triggers them? How will you use them to tell your story?

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 jan