My seven year old has a favorite tree in our backyard. It is an expansive tree with full branches of lush waxy, dark green leaves, providing the best shade on sunny, cloudless days. When every other mature tree was cut down to build our new neighborhood, it was somehow spared, and left to thrive in our backyard. My daughter lies in the hammock under that tree on hot, summer days and reads or swings and sings songs (loudly). The strong breeze on this hill we live on whips the leaves and makes a melodic swishing noise on days when it is fiercely windy. It’s expansive power and the way it takes up space is mesmerizing. It seems this majestic tree is sturdier than most things when the storms come through.
But last week, a storm crashed through unannounced, uprooting rows of the most beautiful old, pine trees that lined familiar worn streets and lay flat large trees on the roads. We awoke in the morning and saw that my daughter’s favorite tree had lost some of its fullest branches while other branches were left sagging and nearly splintering off the trunk. The leaves still remain green and lush on the branches that survived, but this amazing, steadfast tree full of shade has taken a hit. It is slightly sparser and slightly weaker than before. Maybe if you didn’t know the tree like we do, you wouldn’t notice. You wouldn’t notice these branches that once lifted up towards the sky are heaving low and nearly touching the ground. My seven-year-old hopes that it heals and returns to the way it used to be. I hope so too, but I’m not so sure.
It is the day after an evening shift and I am so tired. I am spent. I think about my over-a-decade of practice in Emergency Medicine. It has never been like this. I have always felt pride for the steadfast rhythm of our emergency departments; we have always provided shade for every patient we see. We have had extensive branches, full of leaves and life and have been unwavering. We have weathered winds and storms and bounced right back without blinking. But this storm is really taking its toll. Every shift leaves us slightly more weathered.
I cannot pinpoint or describe to you in one concise sentence what we are experiencing on a daily basis. It is a litany of factors that beat down on us like the cold, sharp, pelting raindrops in a torrential storm. It is the patients that have had to delay their surgeries or medical care that are now desperately and emergently in need. It is the extra weight thrown on those that show up of being short-staffed and lacking essential resources. It is every single hospital being well over capacity, with no place to admit patients that are suffering from the delays in care. It is the ambulance crews that work tirelessly to reach every patient in crisis in the community and bring them to hospitals already overstretched and struggling to manage the load. It is the backlog of patients piling up in the waiting room that are in distress. The waiting. The anxiety. The emergencies that are stacking. The limitless time stuck in a holding pattern.
We all make our own choices about vaccines. We all have strong opinions and will unlikely be changing our minds based on the information we have interpreted as truth. But in the ER, we have no choice but to absorb all the repercussions of opinions and choices that present as shortness of breath that feels like suffocating, fatigue that leaves people devoid of energy to perform daily tasks, body aches that grip patients’ every joint, vomiting that leave people craving for a sip of water to stay down, the unbearable internal heat of uncontrolled fevers, weight loss and muscle loss from not being able to eat, unrelenting intolerable headaches, severe chest pain that causes insomnia, coughs that won’t abate and leave lungs burning and permanently scarred. In the most devastating of cases, we internalize the heartbreak of death, loss, and loneliness. We treat absolutely everyone no matter how their beliefs and adamant choices have affected the condition in which they present. But it is undeniable that what our patients choose has greater than a simple ripple effect—it is tidal wave after tidal wave that is crashing on our shores. They grab hold of us and pull us down with them in this steep downward spiral they have inadvertently chosen. We continue to show up and are unquestionably here to support and temper this downhill slide, but only time will tell if it is too late or if they will make it up from this downward side of the coaster.
We are doing this all while we are navigating our own steep hills. All of this is wearing on us. We are leaning on our own communities and family that carry our weight through this heaviness. We have spirits and stamina of steel. But much like my daughter’s favorite tree, our branches are heavy and sagging. We will show up daily, provide our shade, and stand upright and tall and do what we methodically know we are trained to do with everything we have behind masks, eye shields, facemasks, gowns and gloves. But even the sturdiest of trees will meet its storm.
Our roots are deeply secured and extensive. We hope this storm will pass and not leave us uprooted.
4 thoughts on “My Daughter’s Favorite Tree”
I have been an Emergency Physician for 32 years and yes have experienced some rough patches over the years but this pandemic and the whirlwind of chaos that it has created has taxed even the most seasoned of us. I love medicine and have loved taking care of thousands of patients over the years but I am exhausted mentally, emotionally and physically day after day now. My daughter, presently in nursing school called me just last week expressing concern that I have Compassion Fatigue. I told her, I absolutely do and I’m not sure I even care. I’m trying to find those pieces of my soul that have been stolen by disrespectful patients not taking this pandemic seriously, not being socially responsible by getting vaccinated, administrators asking more and more and providing less and less, our own government making a mockery of this and now passing legislation cutting our salaries and reimbursements even more. When will this all stop? Why should I care anymore?
I appreciated your analogy of the tree and your article! At least we’re all in this together.
I’ve done EM for 37 years. Thought I would I would continue for a while yet but have grown weary for all the reasons stated by Dr. Nelson. Certainly no compassion for us, especially now. I will be done by the end of the month.
I too have more years of practice behind than in front me however in spite of all difficulties we all face each shift, I remain pathologically optimistic. I still am able to find that one patient that makes my shift and agreeably some shifts it can be a tall order. I have the privilege to treat this nation’s veterans and on my worse days I imagine what many of them had to overcome in their lifetime to be in my ER and I find encouragement in this especially when I am able to help them and share a laugh.
I have practiced Emergency Medicine for 37 years and love and enjoy it more in the autumn of my life.
Taking care of everyone including alcoholics, drug users, and the consequences of bad decisions is the bailiwick of our profession. I have been through many flu seasons that have taxed our resources, and yes this is a different beast, but the patient’s suffering is universal. The final outcome of this pandemic is approaching, but how it will approach and the long term consequences of the virus is any ones guess (and plenty of people have an opinion as to how this will transpire, but no one has the crystal ball). And yes, the tree is a great analogy. As long as the roots are deep it will continue to weather the inevitable recurring storms.