Letter from the Editor

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I see my mail carrier about once a week. She usually arrives around 11 am, sometimes later. If I am home, I will wave from the kitchen, occasionally running out with something I forgot to mail in my post-shift daze. We smile and say, “Hi how are you?” and then go about our business. I often wonder how much she knows about me just by the nature of the mail she delivers. A letter from mom in New Jersey, an ACEPNow issue, a college alumni magazine, Fixer Upper reruns playing on the television. Oh, the stories and secrets she must bring home from her daily peek into the lives of the citizens of the city.

As emergency medicine physicians, our daily lives — hence our careers — are composed of collections of short stories.

Several months ago, I saw her picture pop up on the Humans of St. Louis Facebook blog. It took me a few seconds to figure out why her face was familiar. A patient, perhaps? No, it was my mail carrier. Her name is Vera. I had never even asked. The quote next to her picture read, “I just live day-by-day. Minute-by-minute. Hour-by-hour. My son was murdered last year. Shot in the head. 24 years old.” The story revealed how her son, Christopher, had been an organ donor to 5 recipients across the country. Even more coincidental, Christopher’s last minutes on earth were spent in the very same ED where I work.

I wondered if she ever thought about that as she tucked in my emergency medicine journals alongside news updates from the very same hospital where she had touched her son for the last time. I contemplated why I had let all of those days pass without me ever even asking her name. I thought about how reading a story, a snippet from her life, had changed my entire outlook and perspective. How it humanized her, made me feel for her, made me feel connected to her.

As emergency medicine physicians, our daily lives, hence our careers, are composed of collections of short stories. We are drawn to these stories not only because we are caregivers, but also because we are human. We craft our history of present illness by narrating what our patients tell us, and we base our treatment decisions on our interpretation of these narratives.

The problem in emergency medicine is that we often do not have the time for, nor the access to, the entire story. And missing out on the full story takes away from opportunities to heal and connect with our patients. It detracts from our ability to create a sense of mutual understanding, of community. While it is difficult to change the time constraints within the ED, when taking the extra few minutes to sit down and listen, to hold our patients’ stories — their words, their facial expressions, their fears — within our hearts, we might be able to see their needs just a little more clearly.

And just as our patients tell us stories, we feel an inherent need to tell each other stories about our own experiences. Some of these stories are funny, some are heartwarming, some are incredibly sad, and some are otherwise inconceivable. We cannot live through what we see and feel on a daily basis without being able to share these stories with others. Especially in this era of occupational burnout, sharing our stories with each other is a way in which we are able to re-connect with the world, to be able to take a step back, to process, to breathe.

I encourage you to think about the power of storytelling, both the stories our patients tell us, and the stories we tell each other. Whether within the context of initiating palliative care (p. 12), embracing new technology (p. 20), or yearning for an outlet on days when you simply feel you cannot go on (p. 34), storytelling is an indispensable part of medicine and of the human experience.

Vera has not returned to my home. She may have changed routes, or she may have changed jobs altogether. I regret not having said, or listened, more. My hope for her is that if she ever ends up in the emergency department, her provider will listen intently to the story she has to tell. She will mention she is a mail carrier. And for once, an emergency physician will be able to ask somebody else, “What’s the craziest thing you’ve ever seen?” She will tell a funny story. And they will have a good laugh together.

Abby Cosgrove, MD

Abby Cosgrove, MD

Editor-in-Chief, EM Resident, Washington University in St. Louis, St. Louis, MO
Abby Cosgrove, MD

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