“Unit 343, we have a psychiatric emergency on the corner of Le Jeune Drive and Main Street in Miami. Be advised that law enforcement is on its way. This is a Code 3 lights and…” Before dispatch could even finish the statement, I quickly buckled my seatbelt. As sirens screeched in the background, my partner read the sparse details from the monitor and stated that it was a “suicidal ideation” case. As we arrived, the endless possibilities of what we might face inside that muted-green house kept racing through my mind. In the passenger seat, my partner looked both disinterested and unenthusiastic. He apathetically thumbed through his morning newspaper and categorized suicide cases as “boring and common, especially out here in the poverty-stricken pockets of Florida.” In an attempt to tune out his disparaging remarks, I turned my full attention to my first patient.
I vividly remember wrapping the neon-orange safety strap around my distraught and agitated patient's broad torso and loading him into the ambulance with my partner. According to the police officer on the scene, “Tom,” the psychiatric patient, told his mother that he wanted to die and punched a hole in the wall. As I apprehensively sat next to him and took his blood pressure in the back of the ambulance, Tom slowly started to open up to me. He talked about the events leading up to his desire to kill himself and his contempt toward his father for leaving him and his siblings a year earlier. I knew I could not do anything to directly help him, so I sat and just listened. Slowly, my own fear evolved into empathy and the conversation shifted to myriad topics ranging from his aspirations to be a Miami Dolphins football player to his favorite artists. By the time we arrived at the emergency room, both his mind and body were at ease.
As we waited for a bed to open in the ER, I distinctly remember the tears that turned into dry, salty dewdrops that left white streaks across his porcelain, onyx face. In the corner of the check-in area, a designated police officer hovered with a look of surprise and concern riddled across his face as I continued to stand close to the stretcher. The law enforcement agent looked at the patient's tightly clenched, bandaged yet bloody knuckles and deemed the teenager dangerous and a threat. Conversely, by cultivating a strong interpersonal bond with Tom, I was able to truly see and understand his pain but also his infinite potential. Sometimes, “just listening” can go a long way to make a patient feel special; understood; cared for; and, to some degree, better.
To be honest, I don't know whether Tom ever made the high school football team or whether his family circumstances changed. However, I am certain that, for the 35-minute ambulance ride, I was able to make a difference in his life. It seems we too often forget that, at the end of the day, all any one person wants is his or her human dignity and the respect and freedom to have that dignity acknowledged, understood, and fulfilled. What the paramedic characterized as “boring” or “common” is the root of my passion to become an understanding and effective physician. Empathy, compassion, and patience cannot be taught in medical school, and, ultimately, the best and most rewarding lessons are embedded in each interaction with patients like Tom. In the end, “just listening” makes all the difference.
Veena Anna Varki, MS, MPH
DO Candidate, 2019
Nova Southeastern University