Years ago, as I dragged myself towards the finish line of surgery residency, I decided to specialize in surgical critical care, which meant taking care of patients with surgical emergencies. Some patients would have appendicitis, diverticulitis or gangrene. Others would be injured. They’d be shot or stabbed. They’d crash their car or their skateboard. They’d be hit by a semi on the side of the highway as they stepped from their car to help an older woman change a flat.
No one else in my residency had any interest in critical care, especially the trauma part, which was unpopular for two reasons.
Not all the patients were saints, for one thing. Some were drug dealers. Others were drunks on their third DWI. Plus, most of what happened to them seemed to happen at night. You’d be up all night with them when you were on call, instead of home in your bed hoping that nobody dialed your number.
My colleagues agreed that trauma was exciting, but everybody I talked to posed the same question: “What’s it going to feel like taking trauma call when you’re 50?” they asked.
Now, in my 50s, I can answer that question.
I confess that being up all night with emergencies is tiring. By morning, my legs ache and my bunions are sore. If I missed dinner and grabbed a triple latte at 2 a.m., I’m often nauseated by the time I get home.
I’d like to report, however, that trauma call at 50, though tiring, is actually fine. I’m good at it now, better than I was 20 years ago. And I actually like it more now than I did when I chose it .
I like it because it’s unpredictable. Week after week I see things I’ve never seen before. Woman attacked by jaguar at a traveling rural carnival. Tiny man gored by a giant pig. Prisoner who swallowed razor blades so he could escape to a hospital for a couple days. Unbelievably, there’s medical literature about every one of these problems, and as I take care of these patients, I get to read that literature, to learn something about topics I’d never even thought of. I’m a curious person. I always have been. My job is perfect for me.
I also like my job because I like trauma patients. Many of them were doing dumb things when they were injured. They burned their lawn with gasoline instead of mowing it. They choose to celebrate a basketball win by jumping over a giant bonfire. They elected to clean their own gutters at age 84, or to stare down the barrel of a potato gun that hadn’t yet fired. These aren’t capital crimes. They’re just mistakes. Who among us hasn’t done something stupid?
Some of the trauma patients remind me of dumb decisions that I, myself, rejected. They make me feel mature and sensible and for this, I thank them. Other times, they remind me that I’ve emerged relatively unscathed from decisions way dimmer than the ones that they made. These folks make me feel lucky, which I really, truly am. On the days when I forget to remember my luck, I have trauma patients to remind me of the fickleness of life.
Trauma and emergencies are shocking events. They cause people to reflect, to try to understand what happened to them. People who are reflecting often do it by telling stories. Or their family tells stories. Or their friends do.
As a trauma surgeon in my 50s, I find that the best part of trauma care is the stories I hear as people try to reflect on what’s happened to them.
Years ago I had a patient, Mr. E., who’d had abdominal surgery after a car wreck. He came for routine followup about a month after surgery. I asked him how he was doing and what he was up to.
It turned out, he was up to basket weaving, which he’d learned from his grandma, a country woman from the mountains.
I’d known Mr E. for years. He’d sold me my refrigerator and my washer and dryer. He was a big, strong guy. In good health, he could have moved any one of those appliances alone. I hadn’t taken Mr. E. for a basket weaver. It just wasn’t how I thought of him, but we spent most of his appointment talking about basket weaving and his grandmother and how his injury had allowed him to take up basket weaving again after he’d put it aside for the years since her death.
I loved this story. It reminded me how fluid we humans are, how much of us is submerged but waiting to be reactivated by love or family or the whim of trauma. Trauma stories and trauma care have been my entrée into the way that people live and work on our wonderful, big planet. Ironically, the grittiness of trauma care has brought out the philosopher in me.
So, when people ask about taking trauma call in your 50s, I’ll say this: I’m glad I stuck it out this far. I wonder who will come in the next time I’m on call.