I step outside into the cool night air by the ambulance entrance at Valley View Hospital to take a breath and try to clear the webs of fatigue from my brain.
Working as an emergency room physician, my shifts are always full of dangerous possibility. I listen to the night. A distant ambulance wails, the early morning traffic surges past on Grand Avenue in haste.
I consider my career as an emergency physician at Valley View Hospital. Ten years working nights, weekends, holidays, festivals, cold winter nights, summer storms. Through sadness, tragedy, triumph and reflection.
I work in a paradoxical world of absolutes and uncertainties. A certainty that some of my patients will die without emergency care — opening up a blocked artery feeding blood to the heart, giving antibiotics and IV fluid to a patient with a deadly blood-stream infection, a child with a brain bleed after falling from a jungle gym.
Can we reduce traffic by enough to keep our ambulances and police responding to our calls?
And the uncertainty of time. Can we intervene fast enough, can we push intravenous fluid and antibiotics into the body ahead of a dangerous blood stream infection? Can we deliver a baby in those critical minutes with an emergency caesarian section? Can we breathe for a young woman in cardiac arrest, pump epinephrine and IV fluids into her body and bring her back from the brink? Is there time for another explanation or comforting words? Time defines what we do as emergency providers and often determines the outcome of our efforts to save a patient’s life.
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