Until You Walk A Mile....

Until you walk a mile in their shoes

     Several years ago I was working in the ER and an EMS crew came in to drop a patient off to me.  After giving me report, I questioned why they did “this” and didn’t do “that”.  They rolled their eyes and continued their report, I signed their paperwork, and they left.  Their only other words to me were, “If you only knew”.  I took this as a challenge.  Maybe I did need to walk a mile in their boots before I could judge them.  I scheduled a ride-a-long.  I had such an incredible time that I signed up for EMT class, got certified, and ultimately began helping teach that same class that I took myself. 

      A few weeks ago, I saw Dr. Raspanti sitting at one of the desks in the ER stewing over something.  I decided to try to make him laugh because he looked like his night was not going as he had wished.  I thought I would joke with him over a trauma situation in the ER a couple weeks prior that didn’t seem to go smoothly.  He looked up at me with exasperation and said, “If you only knew!”  Apparently that “not so smooth” situation had grown to “full on bumpy” after it was long forgotten in the ER.  “If I only knew”?????  CHALLENGE ACCEPTED!!!!

      I was sure how I would work this challenge out because our trauma surgeons didn’t exactly have a “ride-a-long” program like GEMS did.  After conversations with Angel Ross, Trauma Coordinator, and Dr. Raspanti, I was set up to shadow a trauma surgeon for 2 days. 

      The night before I was so excited I could barely sleep.  Bright and early I arrived at the hospital unknowing of the agenda for the day.  Angel, had warned me to wear tennis shoes, which was later appreciated.  I started by finally working my way into the Physician’s Lounge.  I was very impressed with the set up in there.  After not having a working coffee pot in the ER for over a month, the accommodations for the doctors seemed almost regal.  I began to guess how cushy my day was going to be.  AHHHHH… the life of a trauma surgeon, bring on the bon bons!! 

      Dr. Raspanti arrived, as well as his colleagues, and we sat down to a quick breakfast and rundown of the patient load in the hospital at this time.  The four surgeons in front of me discussed business and threw in light banter here and there.  They laughed and joked at funny stories about themselves and others.  I realized a falsity at this time that is believed by most.  Surgeons CAN smile!!  They joke about faults THEY have themselves, not just all the blundering idiots that they encounter during the day.   This made them seem a little more real to me. Maybe even human. 

      The meeting broke and the race was on.  “What???  We aren’t going to sit around and eat those bon bons I was dreaming about and wait for that annoying little peeper to go off?” I said to myself inside my head.  Apparently not, because Raspanti was in a full on speed walk away from me.  Now, Working in ER’s for almost 10 years I knew how to walk fast so I quickly stepped it up a notch.  We went from patient room to patient room in lightening speed.  The only thing he did not rush was the individual time he spent with each patient.  He sat with them if needed.  He explained things twice if required.  He double and triple checked labs and tests.  He sometimes had to be surgeon, hospitalist, intensivist, neurologist, counselor, and clergy to his patients and their families.  He pushed for the patient to heal with a knowledge of what was going on and not just become stable and leave.  I was under the misconception that surgeons cut, that’s it.   I was quickly learning that was not the case. 

      After all the admitted patients were seen, we headed to his office to see his outpatient lot.  I quickly learned that they shaped his office in a circle for a reason.  #1. Walk, quickly of course, into a room.  #2. See the patient and walk them to the desk. #3. Walk to computer and chart whatever needed.  #4 Back around to another patents room.  Repeat, repeat, repeat, round and round and round.  The patients in his office sat and asked questions which he would answer in detail and in a way that they understood fully.  He made sure that the patient was comfortable with the situation before he left the room.  He smiled at the patient’s families and answered their questions as well.  Yep, I said smiled again, apparently surgeons do it all the time and it is a well-kept secret.  Another surprise was had when he explained to a few patients why he was not going to take them to the OR.  He explained to them he was not just going to cut into them just because he can.   The risks would outweigh the benefits and it was not the best option for the patient.  Another misconception revealed!

      Office time was running slightly over and he had a meeting he had to get to so walking faster was his solution.  I noticed that patient time was never cut short, only his travel time.  In meetings Dr. Raspanti went back into serious mode.  He spoke with others directly and didn’t hold back his thoughts on situations for political reasons.  He made sure that, during a meeting with “Big Brother”, they knew that we were a trauma facility that has a lot to offer.  We were not just here to take Trauma 1 facility throwbacks.  After the meeting I felt taller for being part of THIS trauma center. 

      The second day of my “stalkership” repeated some of the same marathon but included a chance to get in the OR.  I was able to see his hands at work and work they did!!  His procedure was smooth and routine but definitely not boring.  He was respectful to his team and worked with speed and grace. 

My two days following Dr. Raspanti taught me several things. 

*Just because surgeons can cut… doesn’t mean they do.

*Surgeons don’t just sit around eating bon bons waiting for us to call them.

*If your surgeon is late for a meeting, it is not because he does not respect your time. He is just trying to show his patients and their families that respect as well by spending time with them.

*Surgeons DO smile and IF their attitude is less then desirable there is probably a reason behind it.  Sometimes you just need to help them out of it and make them smile rather than threatening to sew their mouth shut with their own hard to find, special sutures. 

*If the surgeon doesn’t want to admit your trauma patient, there may be a reason other than that he is just being difficult.  That patient may go into alcohol withdrawal and become a SICU patient, intubated and unstable.  Going home with his injuries may be the lesser of the two evils. 

*Sometimes there is a method to their madness.  If you don’t understand it, ASK!

*Sometimes they may not understand the method to our madness so EXPLAIN!!

*The time that our trauma surgeons spend with the patient does not stop at the exit to the OR.  They have to follow every aspect of that patient’s recovery.  Sometimes they are more like hospitalists and intensivists, rather than surgeons. 

*Surgeons are protective of their patients.  If you are a consulting doctor on one of their patients, then that is what you do, consult.  The surgeon will decide ultimately what will be best for his patient so know your role.

*If you want to keep up with a surgeon then you need to walk fast.

*Their only existence is not to wait for us to page them to our trauma rooms but they do take every page seriously (even if it doesn’t seem like it).

      I ended my shadowing experience with a greater knowledge of how our trauma department doesn’t just end when they leave our bays.  After learning about what happens before that patient gets to us and now what happens when they leave us, I feel I have a better understanding of the process.  I am proud of how our Trauma Center has grown and hope that my part in it can grow as well.  I leave you with this thought yet again.  Until you walk a mile in their shoes, do not judge!  (And wear sneakers!)