David Galler’s Blog: “Lean on Me”

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28 July 2016:  Swallow Your Pride – Lean On Me.  I love my job as an intensivist at Middlemore, but there are times when it can be particularly grim. One of those was a few weekends ago. I was down in the ED seeing a patient, when I heard the screams of a distraught mother as she ran into the department with her child, lifeless in her arms. He had been run over in a driveway and had the signs of that all too evident across his face.

By the time we arrived in the resus room, his pupils were already fixed and dilated; he had stopped breathing and lost his cardiac output. His circulation came back fast with CPR, intubation, oxygen and fluids delivered through two interosseous needles, but with that came torrential bleeding from his mid-face. Despite all we did he died a short time later in the operating theatres.

The horror of experiences like this are visited most cruelly on the family but also in different ways on our people working in the emergency services in our communities and hospitals.

For us, doing our best to resuscitate and stabilise the patient, from the moment we stop our efforts to continue active resuscitation in events like the one described above, the air becomes thick with a pervading emotion. It is hard to find the right word to describe that, but for me “DISTRESS”, comes close. A disturbing and corrosive feeling of a continual and changing upset, a feeling that can last for ages and make us doubt ourselves, our colleagues and our team.

“Distress” is like energy in an isolated system; it is a force that cannot be created or destroyed, only converted from one form to another. It must therefore be dealt with in one way or another, either consciously or subconsciously, ultimately making us better and stronger in how we live our lives or in ways that can slowly corrode us. That corrosion is like rust slowly eating away at our metal, but more insidious and less obviously coloured.

It plays out in different ways in different people: commonly through a loss of confidence, an ongoing blunting of our joie de vivre and sullenness more often noticed by our families than our work colleagues. Not addressed, it turns us into different people and sometimes, simply kills us.

Life is hard enough without this additional burden, so my message to you, my colleague, is to reflect on this aspect of the great work we do and to think whether it’s appropriate to be more organised in how we address this ongoing workplace danger.

Many departments and institutions have established formal ways to talk about these issues, commonly beginning with a de-brief of a particularly gory or upsetting incident or case, and reviewing the way it was managed and how we all coped. In many organisations, individual members of staff have access to more professional help should they wish to take that up. My enquiries and experience suggest that most don’t!

A few years ago now, I was thinking about all of this when I went to see “Twenty Feet From Stardom” at the International Film Festival and was blown away listening to Darlene Love, singing Lean on Me.

For me, this is a “must see” because it will make you feel good about the world and the brilliance, talent, and creativity that lives there. It makes me feel good about myself and get ready; it made me feel good about you too!

So I say, swallow your pride, let’s lean on each other.

The Film Festival is back again – a winter warmer, it is stuffed full of stories and drama, sadness and joy – a best bet to teach us more about how to capture and hold the joy in our lives. See a film, write a review and send to us at the Medicine Writing Project.

regards, David.