First Day

I swipe my card through the reader. Nothing. Doors remain unmoved. Only a flash of red refusal from the LED panel.

I swipe again, Red.

Again, Red.

I furiously swipe once more, my face now a glowing reflection of the LED’s inevitable choice of colour. Still nothing. I frantically scan the door once more. The sign above still reading “Emergency Department”, although I’d half expected it to have changed. Ready to give in, I turn in place; a young lady in navy scrubs spotting my pleading expression.

“First day?” She asks, hand smoothly running her card through the reader. A mocking flash of green from the panel signals the doors to stutter to a start, seemingly still reluctant to let me enter. Thanking her, I stride through the doors, renewed with a little hope. “Oh” I hear from behind ” you see the next door over?” she giggles at the look of bewilderment on my face. “You don’t need a card for that one, probably best use it next time.”

 

I quickly shuffled over to join a handful of my colleagues stood at the end of a long central work desk. “Any ideas who we’re supposed to be meeting?” I ask, my eyes scanning the rows of navy scrubs-clad figures working along either side of the table, all seemingly oblivious to our arrival.

“ Not sure, but the doctor over there said if we just waited here, they’d likely find us” I followed the line of my colleague’s pointing finger to watch a navy-scrubs wearing lady dash into one of the many cubicles indented within the surrounding walls.

“Ah. right” I reply; wondering to myself how on earth someone we’d never actually met would have any chance of finding us. But I was quickly enlightened by a glance over at my colleagues. A gaggle of smartly dressed, young and incredibly, lost looking people standing uncomfortably in a hospital could only mean one thing. Medical Students. So with this in mind, we set to doing what medical students do best. We loitered.

 

“Ah, you must be the students.” Standing to attention we turn to face the tall man who’d just interrupted our loitering. Without a word, he begins pulling out his stethoscope, a number of different pens and couple of venepuncture vials, and finally pulls a square of folded paper from the pocket of his crumbled scrubs. “Going to need to write down your names. I’ll never remember them otherwise. You’ll probably have to get used to that unfortunately,” he says with a chuckle. After some quick introductions he stuffs the paper back into his pocket and quickly scans the department. “ Right lets go find you some patients!” he says. “Any Questions?”

I did have a question. On TV and on the news, the emergency department is always chaos. You see images of beds in the corridors, doctors crying in the cupboards and angry patients who’ve waited 8 hours to be seen. I knew that was all dramatised, but when I’d seen “emergency department” on my timetable, I hadn’t expected to see just a handful of peacefully waiting patients, beds in their rightful positions; some even empty, all with a distinct lack of tears. “ Is it always this q…” But before the Q even left my mouth a loud beeping erupted from his pocket. It wasn’t going to be quiet anymore.

We followed the tall man to the resuscitation room; an elderly lady was on her way in by ambulance, found unconscious by the staff of her care home, she would need his help. The resuscitation room had a different feel to it than the brightly lit department we’d just left. The only light sources were the dim ceiling lamps and the thin window slits sitting just beneath them; casting a long shadow over the entirety of the room. We found ourselves clinging to a long desk jutting out from the wall and spanning the full length of the room. Opposite us sat two empty beds, anxious to receive.

Within seconds the resuscitation room was filled with activity. My fingers gripped the desk harder, nails digging into the wood; if they slipped off, I felt I’d be dragged into the whirling chaos before me. Bags of fluid were now hung up; placed on stand by. The crash trolley, wheeled into position. A selection of needles, cannula and monitoring equipment laid on top of it. With the ECG set up, the final piece of preparation was in place. They were ready; all eyes turned to the double doors at the end of the room and silently, we waited.

 

It wasn’t long before the whining of hospital bed wheels outside the door interrupted our silence. The doors swung open and the room once again erupted into a flurry of organised chaos. As a medical student, even as an adult, I’d never seen someone grievously ill before and I didn’t expect to do so on my very first day. But hidden beneath the tangle of wires, probes and gloved hands, lay a small, elderly lady, completely motionless; her eyes loosely closed. People had always said to me that dying is like falling asleep, yet I saw no resemblance to sleep here.

A large group of doctors and nurses worked furiously around her, carrying out tests, examinations, trying to save her. But despite the needles, the drips and the wires, this lady’s motionless form gave little indication she noticed any of it. Only the irregular beeps from the monitors above indicated she was still with us, still fighting. However, it wasn’t her lack of movement or fading vitals that told me she was seriously unwell. It was her skin.

The rosy pink tinge of life was gone, sapped from her skin by the infection trying to overcome her. Leaving only white and grey. Grey lips superimposed on china white skin. The lines of emotion on her face, ever visible on even the most reserved individual, also gone. The flat, expressionless grooves now totally unreadable. Yet these signs told us more than any monitoring equipment ever could; she didn’t have long left.

The decision had been made; there was nothing more we could do. Heads sinking, we all left, leaving her precious last moments to her daughter. Despite the relentless efforts of the nurses and doctors that afternoon, despite the tests, the fluids and the drugs there was still nothing they could do. Every day on placements you take something away. A new disease, a new drug, new lessons. But this I hadn’t expected to learn on my first day.

Sometimes there is nothing you can do.

 

First Day