One more down, one to go

My time at the Oregon Burn center is officially done. On this rotation I’ve seen an amazing team of health professionals taking care of some of the roughest injuries I’ve seen in my four years of medical training. During my first week on the unit we had a multiple fatality event that brought several people in to get care from the burn unit. During this very busy and sad first week, I helped with the evaluation and stabilization of multiple trauma admissions and ultimately witnessed a very sad outcome that gave me an opportunity to understand the process of declaring a brain death and decisions that influence organ donation decisions. Important learning opportunities for which I am humbly grateful, but difficult nonetheless. Often the thing that makes witnessing a tragedy hard is the personal connection - a patient with your mother’s name, your child’s age or your best friends shoes. Watching patients die is never easy but within that busy tragedy, there were some personal connections in this tragedy that rocked me off my center.

I also learned that, for the most part, people who get burn injuries rarely have simple stories or health histories. They often have seizure disorders, cognitive impairments, addiction, strokes, homelessness, etc, that can lead to risky situations like exploding lighters or burning trash piles. These patients have complicated courses, with multiple surgeries and long recoveries. Occasionally the cause of injury is a workplace or leisure accident - just an otherwise healthy person who gets splashed with hot oil or falls into a fire or spills hot liquid on themselves. These injuries are deep, they take a long time to evolve to show their final damage and they are hard to fix. They leave their marks, despite the skilled surgeons working on them.

One of the most amazing things I have seen on the Burn unit is joy. I can’t tell you how inspiring it is to watch someone have true love for their work, especially when their work involves some pretty gruesome stuff. My experiences with surgeons have been mostly with intimidating, skilled professionals who take their jobs really seriously. I never had anyone throw a scalpel at me or anything like that, but I did have attendings who ignored me or just referred to me as “med student” and a fair number of over-tired and unhappy residents who may not have made my life miserable, but they sure didn’t go out of their way to make it any better. Playful is not extra work, it doesn’t impair productivity, communication or teaching and learning. Playful just reminds everyone where this work is coming from - the heart.