A Shoulder to Lean On
Castrenze Fricano (M.D. ’19) is a resident physician at the University of Washington Medical Center.
Very shortly after arriving at the rural Minnesota hospital where I was to complete an entire year of medical school clerkships, I was given a pager and placed on the call list for all cardiac arrests, trauma activations, and rapid medical responses.
One evening, I was paged for a cardiac arrest in the emergency department. A team of nurses and doctors were assembled, working vigorously on a middle-aged man. My first instinct was to grab a set of gloves and assist in the resuscitation. But the gloves were in the corner of the room, and with everything that was going on it was just easier to go outside and grab them from a cart.
As I did that, I saw a woman crying. I reached for a pair of gloves and turned back to go join the resuscitation team.
But then I stopped.
I’m not exactly sure why I paused. I was at that hospital solely to learn medicine, and certainly what was happening in the room— however unfortunate—was an excellent learning opportunity. Yet instead of going in the room, I turned to the crying woman. She was the patient’s wife.
Part of me still wanted to participate in the resuscitation, but I stayed with her. I think I figured I already had been part of many cases involving cardiac arrest, and that her husband was receiving excellent care. I knew I could have a greater impact if I stayed with her.
We were standing outside the resuscitation room, but we could see everything that was happening. I can imagine what she saw seemed barbaric, the things we do to “help” people. She couldn’t stop crying.
I proposed we find a seat somewhere so I could explain what the team was doing—but also because I thought it best to spare her from the sight of the ongoing resuscitation of her dying husband.
At first, I tried explaining everything in very clinical terms, which did nothing to ease her crying. At some point I remember stopping and just saying how sorry I was. I sat next to her on a hospital bed. She couldn’t see my face, but I had started to cry, too. As the medical team worked to save her husband’s life, I put my arm around her shoulders.
After about 10 minutes, there was a pulse. Even though the woman was so happy and thankful, I knew her husband’s prognosis was grim. He had been in cardiac arrest for a rather long time, and though he had “survived,” the ultimate outcome was likely not pleasant.
I did not share this insight with her. Maybe this was the best outcome, as now she would have more time to process everything. The woman thanked me just before she and her husband left on an ambulance to go to a larger hospital that offered a higher level of care. I wished them both well.
This was one of the hardest days in my medical career thus far. But it made me realize that I have so much more to offer than my medical knowledge and clinical skills. Sometimes just being there—to talk to, to comfort, to alleviate suffering—might be what’s most needed.
Adapted from an essay that originally ran in the online journal EM Resident (https://www.emra.org/emresident/).