In large hospitals, there are often lots of people. Such a simple but sometimes under appreciated thought that is obvious yet equally as oblivious to the challenges faced by others. In an environment when there are multiple teams, there might always be back-up. There are pros and cons to having so many people, but one thing is clear: Not every where can afford the shear number of bodies.
Ironically, the smaller the hospital, sometimes the better emergencies are handled, even in less resourced arenas. With smaller groups of people, a close camaraderie forms, trust is more vital than breathing, and understanding becomes silent. Team dynamics become more ingrained, visions become shared and mind-reading becomes oddly easy to do. I assume that in many job fields this alliance is formed and that there are many different places in the world where these situations occur, but sometimes they aren’t always brought to light.
My favorite part of these small triumphs is the bonding moment when a call is made for All Hands on Deck. One of the reasons I chose medicine was to be part of these teams. One reason I chose to become a doctor was to lead, learn and share from the people around me. Some people prefer to be the driver, some the passenger, and some the back seat; but, when there is a crash everyone is equal and survival is codependent.
I will never forget the night when one of my most respected OBGYNs called for a STAT C-section – the baby’s heart rate on the monitors was going down and not coming backup, delivery via surgery could determine life or death. We ran into the operating room without our full operating room staff. Anesthesia showed up luckily on time and prepared for general anesthesia. One of my nurses on the regular floor ran to shuffle through unfamiliar cabinets to open up tools and supplies. Another in unfamiliar terrain looked to plug in suctioning and the cauterizing device to stop bleeding. I quickly scrubbed in after pushing the warmer to the wall and setting up everything for the resuscitation – this would normally be done by one of the nurses but she was looking for a knife for the surgeon. I will never forget, “Someone. Give me a knife. Something sharp. A box-cutter, I. Don’t Care. We need to go NOW.” – I hope this surgeon knows how much I respect her. We moved and flowed as fast as we could, the remainder of the OR team finally getting there late slightly later, the circulating nurse was a traveler unfamiliar with the location or flow of things. The surgeon cut, the baby was pulled out, and everyone, including the baby, cried.
I was first introduced to the term “trauma bonding” after a rough intubation of a sick baby with the anesthesiologist. I had gotten it first and stabilized the baby but on the way out of our hospital it had some sort of obstruction in the tube and things began to go downhill immediately. She turned grey, her heart rate dropped and chest compressions were started. Luckily the anesthesiologist was able to replace the tube as the ER nurses and respiratory therapists stood. I watched that baby start to die and then come back to life.
There is something beautiful about the way a small group of people can make a difference. There is something beautiful about emergencies when all hands are needed and a cohesive bond is formed among a team. Synchronicity is not easy to come by and takes many times to perfect; but, is absolutely beautiful when it happens. Humility and ego go out the window, life-long connections are forged, and the meaning for why we do what we do becomes so much more clear. As I continue on my early career and beyond, I am always hoping to enhance and upgrade the efficiency of these teams so that when all hands are on deck, the boat can be saved.
The Nomadic Pediatrician 