Project 1

Regen Morgan

1/29/2018

ENC 2135 15

Professor Wenzel

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I had the realization that the ER is not like what you see on TV, during an overnight shift shadowing Dr. Heringhaus in downtown Columbus, Ohio. The night started out calm and steady, but anyone who is familiar with the ER knows that this doesn’t last for long. When Dr. Heringhaus was informed by triage that a trauma patient was coming in, there was a mixture of excitement and worry surging through our bodies. We had been told that a teenage girl who was pregnant was coming in due to an injury falling in the shower. What initially sounded like a simple injury quickly became one of the worst things I had ever witnessed. When I walked into the trauma room I saw a young girl being moved out of the ambulance onto a hospital bed. She was visibly in pain,  she was not moving and she could only briefly respond to the questions that she was asked. Dr. Heringhaus pulled up her shirt to examine her abdomen and baby and what I saw caused my stomach to drop. There was a significant amount of bruising and swelling on her stomach, and these injuries were not consistent with a fall in the shower. I had a gut feeling that something was suspect, and many of the doctors and nurses in the room also had a troubled look on their faces. Dr. Heringhaus quickly performed an ultrasound, and there was no heartbeat, the baby had already passed away. The patient was wheeled into her room as Dr. Heringhaus began to document the case, being extremely careful with his wording. He used words such as “injury” and “patient”, being sure to avoid any controversial words or phrases. He told me that if this case went to trial he wanted to make sure that his wording was perfect, and that he always tries to state only facts in his report. I asked him if he thought she fell, and he said that he couldn’t be sure, but those injuries were not consistent with a fall.

The patient’s boyfriend came into the hospital looking for her, and suspicions began to grow throughout the hospital staff. The theory that began to form was that the boyfriend beat the patient and in result the baby had passed away. Both the boyfriend and the patient seemed to show no remorse over the loss of their unborn child. They were having everyday conversation, which was concerning because the patient was extremely ill and still at risk. Not one tear was shed over the loss of this 20-week old unborn baby, and the boyfriend was acting as if the patient was suffering from a minor injury even though she was severely injured. My heart hurt, I simply could not understand how the loss of their future baby had no effect on them. I tried to remain stoic, when you work in a hospital you have to remain calm and rational at all times.

Dr. Heringhaus paged the OBGYN, and he found the social worker in the ER and explained the situation to her. She quickly made the decision that the boyfriend needed to leave the hospital to allow the patient to feel safe to talk. When asked to leave he went without any argument, but the lack of emotion from him was evident. The social worker began asking the patient if she had ever been hit or if she had trouble at home, but she was quick to deny all of this, and she even got angry after being asked several times. Meanwhile Dr. Heringhaus and I moved on to other patients, but this case really stuck with me. As we were documenting another case, a code blue was announced over the speaker system and the OBGYN was asked to go to the room immediately. A code blue means that a patient isn’t breathing or their heart is no longer beating, and if you hear code blue you know that it is not good. As an Emergency Medicine doctor you don’t get to follow a lot of your cases, which is a troubling feeling at times. To this day we are not sure what happened to this girl, but I always hope that she made it and found the courage to speak out against her abuser if this was the case.

            As we continued working the 8-hour shift, I felt a sense of guilt. It is a troubling feeling to want to save someone but to be helpless. Dr. Heringhaus told me that he was glad I got to see this case because these are the ones that are the toughest. He told me that in his opinion, the patient would be extremely lucky to survive due to all of the blood in her abdomen. After the code blue was called, he wasn’t very confident that she was going to make it. He told other doctors and nurses the case, and everyone was disappointed and could not understand who would do this to someone. As I was following Dr. Heringhaus into other patient’s room and listening to their small injuries or list of symptoms they had been experiencing, I found myself still thinking about this case. I started to wonder if I was cut out for this field, and I realized that I needed to learn to detach my emotions from patients and cases. Every skilled doctor knows how to do this, and I watched Dr. Heringhaus use this skill time and time again. He made it very clear to me that as an Emergency Medicine physician, your job is to give patient’s fair treatment and give them all of the tools they need to heal, but your job is not to save everyone. He certainly tries to save everyone, but he knows that at the end of the day you can’t save someone that doesn’t want to be saved.  As I walked out of the hospital that night I felt as if I had found my passion, and had grown as a person and a future physician.

          

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