The Truth About Life That Only Unfolds in the Emergency Room
But applies to every room in life.
18th October 2020 was the first time I saw someone come back from the dead.
The ECG had flat-lined. The woman’s chest was no longer heaving since we stopped the air. Her mouth hung open and there was a heavy piercing silence as we counted down to the time of death.
Then as if struck by lightening — a current ran down the body. The heart-rate monitor picked up, like an incessant song of rebellion from a cardinal in the snow. I could feel tears form in the corner of my eyes as the team swarmed around the patient again.
It is the most magnificent thing I have ever felt in my medical career.
It’s one of those things that makes you fly off your rockers and become extremely grounded at the same time. Bringing someone back from death can make you feel like god. On the other hand, if things go south then also extremely helpless in the hands of fate.
Unlike reviving people, there are things you learn in the Hospital ER that can be taught in a 6 minute article. Things that also break you into another realm of existence. Things that everyone ought to know. Things that I am about to share with you.
Life can turn upside down with one finding on a routine test
We see people come in all the time just getting their routine tests or getting their medications updated. Then they learn about a bump the doctor found; one that they or their partner hadn’t noticed before. They are asked about a mole that didn’t looked so different to them only yesterday. They see the numbers on a normal blood count come out a digit to the right.
These isolated moments can take your life and body slam everything you thought or believed in. They turn around and recalibrate what the future looks like for you.
I’ve seen people bawl their eyes out, fall into a stunned silence or go into a state of disbelief.
But you’ll be surprised to hear how people become once the shock wears off.
When suddenly faced with the knowledge of their mortality, it feels as though your spirit has left your body but easing into it is often peaceful. Don’t believe me? A 2020 study amongst many others done after physicians reported the lives of their patients improving for the best states as much is true.
“In the multivariate analysis, the cancer patients and informal caregivers were happier than the healthy people in the general population, even after controlling for age, sex, educational level, and income.” — de Camargos, M.G., Paiva, B.S.R., de Oliveira, M.A. et al.
I have seen patients come in months after a heartbreaking diagnosis — smiling wider, hugging their family or telling them how they feel with less hesitation. I’ve had patients’ families tell us that they feel freer and fearless. Not reckless.
Simply set free by the knowledge that just like everyone else, their time may also be finite. That makes them rethink value systems and their perceptions that they may have resigned entire lifetimes to.
A diagnosis such as this could completely rewrite the lazy sweet ending we contemplate for your life. The one we no longer curate or revisit while we revise the same design for a crappy client 6x in the same day.
My patients came back for follow ups, and they were full of life like they had never lived before. There was no talk of the about the business they spent a lifetime building or the 9 to 5 corporate slavery—while those conversations are usually directed at families and support systems. I have been told time and again by caregivers about how a patient’s priorities realigned. That they can hear the voice of reason clearer and louder than ever.
The mindfulness that comes when you learn you might have a life-threatening disease that challenges the amount of time you thought you have — can be instilled long before being in that position.
Through constant reminders of mortality and keeping in sight how unexpectedly life could change over the course of a brief moment.
Our outward journeys in search of superficial successes are guided by external forces that take control of life and make home, health and hearth take backseat. Yet it is the inward journey that transforms us when faced with mortality.
The truth is, the inward journey is the only one that ever matters.
Expressing yourself in a few words could save a life
If you’re a poet or a writer, you already know this. The essence of a piece of writing can at times be in leaving your audience wanting more.
Brevity with words can be your best friend whether it’s for the sake of closure at the end of a bad relationship, writing to a colleague to sort out a misunderstanding or talking your way out of lie.
An interesting article by the name of “Evidence for the Pinocchio Effect: Linguistic Differences Between Lies, Deception by Omissions, and Truths” explores the phenomenon of liars using more words although having the same word count as truthful counterparts.
We are biologically designed to respond to those who speak in a concise manner with trust. Those who talk at length often talk themselves into loopholes created by their own negligence.
In the ER, communication is efficient and effective. If you don’t know what I’m talking about then see a Resuscitation team managing a crashing patient in the ER. The jargon hits the layman like Braille for human ears.
While there are situations where expressing at length is the only way to get through to the other party and elaborating an opinion might display clarity of thought — those moments are few and far in between.
It is rare that we think back to a moment and wish we had said more — unless that moment is laden with feelings. More often it is when we say things while riding an emotional wave, that we say stuff we can never take back.
The lesson is to do your best to be brief specially when talking from a tight spot. What compromises your position even more than the number of words you use however, is if the amount of knowledge you have doesn’t match up.
Question what you know often and then once more
I was trying to keep composure while taking medical histories from 5 members of the same family while a familiar old man who was brought in lay unconscious on the ER bed a few feet away.
He was stable and we had decided to shift him to the medical ICU but we still couldn’t determine the cause of him losing consciousness. As it turned out, the man was one of the biggest athletes of the country in his younger years. Even after he stopped playing his sport internationally, he ran marathons and maintained a topnotch health.
The biggest dilemma in all of this? His wife was in blatant denial of his state. Even leading up to his appearance at the ER.
She was so sure he was a sound sleeper due to being active all day long and hadn’t be in a coma before that moment(or even then) that it made it difficult to arrive at the diagnosis.
A junior doctor had picked up her denial the moment she walked in and dismissed the history provided by her on the grounds. The team still did their best to scan the information provided by her and other family members that would be important for the Emergency treatment provided to the patient on the spot.
Out of habit, I kept poking at her till this 60 year old women mentioned noticing that her husband had been to a nearby clinic for routine tests. She later found a machine used to check glucose levels and a bunch of unused test strips in the bin.
She thought this was discarded equipment as she could only describe the machine, not its purpose.
It wasn’t just her who had been in denial. Her husband was in a diabetic coma and didn’t come to terms with his condition back when it was preventable.
By that time, the tests had guided his emergency treatment.
He was out of danger. But there was a way all of this could have been avoided from the moment her husband found the results of the routine tests.
For an athlete who had maintained his health and actively taken measures to be in the best shape —being diagnosed a Diabetic is much harder than most people. But it didn’t have to be the life-threatening situation that it turned into because he stuck to his fears regarding Diabetes.
He had seen his own grandfather succumb to Diabetes as he was put on a Dialysate machine towards the end of his life. He was not prepared to challenge what he had seen as a child.
Had he sought counselling from a GP and shared his concerns with his family; his journey could have been much easier.
In life, we often tend to build templates for situations that impact us the most. When faced with a similar situation again, we resign from active decision making or attempting to diverge from the knowledge that we have gained from isolated events and act to confirm prior bias.
While on one hand, it reduces decision fatigue and makes us more efficient. On the other hand, it predisposes us to continue with a plan despite red flags only because of this behavioral bias.
This is no non-fatal behavioral bias either, it’s one that has been vastly studied and documented when NASA trained aircraft pilots couldn’t change their course of flight due to a psychological investment in it.
Much like the kind of investment we subconsciously make while seeing something painful unfold in front of us — and commit the template to memory for the rest of our life.
The Habit Lab at University of South California studied the crucial role context plays in cuing the behavior of individuals if they have been previously impacted by a similar situation.
Scientists suggest the best way to break this pattern is to change your scenery often; the friction makes your brain ready for encountering similar situations with a fresh perspective despite all demands to the contrary.
Recall
- We are all one routine test or accident away from being jolted into existence with a ticking timebomb attached to our collar. Don’t let life get you there for you to be paying attention and setting priorities straight.
- Speak efficiently when in a tight spot.
- Question your existing templates for situations you have encountered before. Break the pattern to gain new knowledge and avert disasters.
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