Say Goodnight

night parking lot

Click the audio player above to hear a reading of the essay by author Harrison Reed.

 

     The clock strikes 7 and my brain turns back into a pumpkin. All of the stressors from my shift—held at bay for 12 hours by a sense of duty, a focus on the immediate—tumble from their hiding places.

     There’s the coffee I spilled down my scrubs before the day began, a new admission that rolled into the unit without warning just as I arrived, the needle that refused to find the tiny, throbbing hint of an artery in my patient’s wrist. There’s the unexpected computer system downtime, the family feud that erupted in the lobby, and the specialist who delivered his expertise in a curt, sarcastic package.

     By the end of the day, the pile of those small offenses feels like a mountain. And a handful of victories are forgotten gems buried in the mess.

     My relief arrives, fresh for the night shift and ready to start building her own mountain. I hand off the remnants of my work, pack up my stethoscope, and grab my coat.

     “See you tomorrow,” my coworker says. After an exhausting day, the pleasantry feels like a cruel taunt.

     “Yeah,” I say. “See ya.”

     There are fewer than 12 hours before my next shift starts, and after accounting for time to travel, eat, and sleep, it might make more sense to pitch a tent in the cafeteria. I remember reading about a girl who quit her job in New York City to scoop ice cream in the Caribbean. Maybe she knows something the rest of us don’t. Who doesn’t love ice cream?

     My legs are on cruise control and I’m almost to the massive revolving doors guarding my path to freedom when a thought springs from my subconscious. My brain tells my feet to stop, and they are only too happy to comply. I turn 90 degrees to my right, away from the exit, and walk deeper into the hospital.

     Somewhere in my muddled mind is the image of a man with striking eyes: light brown speckled with bits of sky blue, like they were crafted by a delirious, indecisive genius. I only saw them for a moment as I pushed his stretcher into the OR. They had fluttered open when his daughter whispered into his ear, flashed with a single moment of recognition, and closed again. Earlier today I left that man while his heart struggled in his chest, his fate no longer in my hands.

     Now, as night settles on the hospital and the drone of activity no longer echoes through the halls, I make my way back toward that same OR. But just before the restricted doors, I veer toward a room with soft light, padded chairs, and hushed voices. My eyes scan each of the hopeful faces that turn my way, searching for someone familiar. I find her in the far corner.

     I pick my way through the waiting room, a campground of families starving for good news. I reach my patient’s daughter before I have time to wonder why I am not halfway home, why I felt compelled to make this pilgrimage. But as I stand in front of her, she looks up and smiles.

     “You again,” she says.

     “Yeah, me,” I say. “How is he?”

     “They say he did well. He’s not out of the woods. But he did well.”

     Relief bubbles from my stomach and catches in my throat, that mountain I tried to carry out of the hospital forgotten for a moment.

     “I’m glad to hear that,” I say.

     “Thank you,” she says. “For everything you did for him.”

      “You’re welcome,” I say, wondering if I have justified my intrusion into this fragile place. “I, um, I just wanted to wish you luck. And say goodnight.”

     She nods. “Goodnight.”

      In a moment, I’ll retrace my path back to the hospital atrium and my ever-diminishing reprieve from work. I’ll rewind the day in my head as I cook dinner or, more likely, stop somewhere for take-out. I’ll turn the TV to a random channel to fill the air with conversations that have nothing to do with medicine or disease. I’ll consider scooping ice cream in the Caribbean.

     But there will be a sense of levity that didn’t exist before, a buoyancy in my chest. For me, it was an accidental discovery, like penicillin or Silly Putty. But I have a tiny cure for the mountain that tries to follow me home: find someone who carries an even heavier weight and has even further to go. Put away the stethoscope, look them in the eyes, and grip their hand.

     And say goodnight.

 

 

 

“Say Goodnight” was originally published in the May 2017 issue of JAAPA. You can read it and other narrative essays at JAAPA.com.

Author: Harrison Reed

Harrison Reed is an emergency medicine and critical care physician assistant (PA-C) in Baltimore, MD. He is the Associate Editor of the Journal for the American Academy of PAs (JAAPA) and regularly contributes to the New England Journal of Medicine's In Practice blog. He is the creator and editor of The Contralateral.

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