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A heartfelt plea: the power of emotions in health care

I leaned over the bed’s railing, straining to hear the morphine-slurred words spilling out of his chapped lips. “Make them stop laughing,” he said, referring to the cohort of young nurses giggling around the code cart in the hallway. “I’m in here suffering, in pain, and I shouldn’t have to hear laughter. Tell them to stop. Tell their boss. It’s so unprofessional.” After spitting out the last spiteful words of his diatribe, his pupils constricted, shoulders relaxed, and he sank back into the opiate bliss that swept away his minor post-operative pain. My mind raced in the space between his sonorous respirations as I rehearsed a reply I would never say.

“Sir, let them laugh. Let them be human. Let them cry and rejoice. Let them ache and remember. You see youthful skin, unlined faces. I see innocence washed away with the blood on their hands. Sir, let them laugh.”

I struggled to auscultate breath sounds in the young boy’s chest over the eerie, keening wails of a woman in the hallway. A respiratory therapist stepped quietly through the doorway, one hand fumbling with oxygen tubing, the other hastily wiping tears off his face. My patient’s mother stared at him in abject horror and began to shout, “You have GOT to be kidding me. What is WRONG with you people? Make that woman stop screaming! I don’t want to hear crying. I don’t want to SEE tears. This is all so upsetting to ME. You have to make her stop!” I can only hope the nebulized cloud of albuterol now permeating the room blurred the look of utter revulsion on my face.

“Ma’am, let them cry. Let them moan and roar. Let them shriek to a calloused God, beseech an apathetic Fate. For a mother’s heart lies shattered on our trauma bay floor, mixed with the blood of her baby girl. Her arms ache for the finger-paint-covered ball of fire that used to wriggle against her chest, but now lies cold and still among the resuscitative debris. You see a respiratory therapist with offensively injected sclera. I see a young man with steel resolve, unblinded by tears, who terminally extubated a preschooler. You see a staff with shaking hands and defeat in their eyes. I see an army of healers, beleaguered and abraded, who grappled with Death in the darkest hours of the night. Ma’am, let them cry.”

Nauseated with fatigue, my back tight with stress, I shuffled into the elevator and nodded at the man leaning against the opposite wall. His persistent attempts to engage me in an upbeat conversation barely registered in my sleep-deprived haze. Then his tone changed. “You know, you women would actually be a lot happier if you smiled when we told you to. So stuck up, you can’t even crack some jokes with me in an elevator. Just standing there with that ugly look on your face. Why don’t you go take a Prozac, or meditate or whatever?” Bare knuckles turned white as they wrung fury out of thin air; it was all I could do to restrain the daggers that threatened to launch themselves from my gaze.

“Sir, let me frown. Let me grieve and detach. Let me mourn and withdraw. Will your Prozac erase the feeling of warm blood gushing down my arms, dripping onto my shoes, as a thoracotomy revealed a teen’s shredded aorta? Will smiling drown out the ghostly orchestral tone of gurgling last breaths that pervades my dreams? Will meditation make me forget the acrid smell of charred human flesh: an amaroidal scent that has haunted me long after I watched a mother burn her children alive. Will laughing at your jokes distract me from the morbid cinematic reel replaying in my head? From those gritty images of my gloved hands delivering a stillborn baby, a decaying angel, into the hands of his sobbing mother? No? Then sir, let me frown.

We are the front line. And the second. And the last. We can be saviors in wrinkled scrubs. We can be hope in human form. But we are also human. Let us be human. Let us cry, let us laugh. Let us frown. Let us scream. Let us tremble with exhaustion. Let us stumble and fall. Let us hold you. Let us hope with you. Let us swaddle your newborns. Let us comfort your elderly. Let us grin with you. Let us rejoice with you. Let us help you ring that survivor’s bell. Let us be human together, embracing every emotion in that motley living spectrum. Let us build a more compassionate future.

Let us feel. Let us heal. Together.

Victoria Goodheart is an emergency physician.


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