meaning in the night

I’ve been carrying the feeling of disorientation and a slight sense of derealization with me throughout the past week. After a three-month hiatus from working overnight shifts in emergency rooms, I returned to work last week full-force. Switching the sleep pattern is always a bit tricky for starters. But it is more than just that, more than just the disconnection from working while everyone else sleeps and sleeping while the world is awake and alive.

It is hard to describe but the overnight work shifts always feels slightly nostalgic of some dream-world, a place I have visited plenty of times and yet also a place so foreign and always mildly unfamiliar. Maybe it is the uncertainty of what happens in those emergency rooms, life and death hanging by fragile threads through which I find myself carefully treading. Maybe it is the intensity of the work, the patients I see either animated beyond hysteria or so lost that the dark tunnel of death is the only path they can see. Or maybe it is something more than any of this, something indescribable that happens during those blackened hours when the world sits in silent anticipation before the cacophony of screams and gagging and tears that flood my senses as I enter the emergency rooms.

It is intensely emotional work, and yet it is work that I find more fulfilling than I can explain. It is work that leaves me with tear-stained cheeks when I arrive home with the sunrise but it is also work that pushes me beyond my boundaries of comfort into a place where my mere presence has the potential to touch the troubled souls of these patients. And in those moments when I find myself pushed beyond my boundaries of comfort, the strangest thing occurs. In those moments, I do not realize my own discomfort. I do not allow myself the possibility of acknowledging my own anxiety. It is only later, on the long drives back home from these small mountain towns, that I realize my actions would have shocked those who know me best. In fact, I find that I am indeed shocked at my own actions. And yet I am also proud. With tears of compassion, prayers offered in hopes of healing, and these shocking realizations, I make my way home down quiet interstates, the silhouettes of smoky blue mountains rising behind me.

I knew to expect a return of these emotions when I returned to work last week. I knew that the sleep deprivation would leave me frazzled and detached in daylight hours, that the sunrise each morning would quite possibly be accompanied by tears for the patients I had seen. I knew that some of these patient’s stories would linger in my heart, staying with me in the coming days and nights. And I knew that I could not possibly know what any individual night of work would bring to my life.

Many nights were spent making these drives to small rural towns, places where upon arrival I realized that patients and hospital staff often knew everyone around, except for me. This is a new region that I began working last week, the region of “mountain” hospitals, emergency rooms hidden away from the lights and anonymity of the city. Maybe the “small town feeling” contributed to the heart-touching nights of this past week. Maybe it was the events that have unfolded in my own life over the past three months. Either way, the nights found me sitting beside the beds of patients, listening for longer than necessary, offering words of encouragement and comfort beyond the standard questions and assessments.

There is one specific event that has continued to stay with me throughout the days and nights. This case involved a teenage girl who had come to the hospital after feeling dizzy and nauseated during a period of hyperventilating and what her mother believed was a very severe panic attack. The doctors believed the teenager had taken drugs, her confusion and disorientation, hallucinations and babbling, presenting the picture of someone having a bad “trip”. As she tried to talk to me, she suddenly began vomiting and the strange symptoms worsened. Anyone who knows me knows that I have an extreme phobia of vomit. Yet I stood in her doorway, ignoring the retching sounds and acrid stench, making sure her mother was safely by her side while I found a nurse. After the vomiting episode, the nurse came to give her a shot to ease the nausea. This child was terrified of the needle, her body literally flailing off the bed each time the needle approached. Without thought, I put one hand on her head brushing back the strands of hair stuck to her sweat-drenched face while the other hand gently rubbed her back. With words of reassurance and comfort, her body calmed beneath my hand and the medicine entered her body. Even while writing this, I am aware that these seemingly small gestures probably do not seem very important to most people. It is not the gestures themselves, but more the fact that my body naturally engaged in these actions without thought or anxiety that astonishes me. But even this is not the part of the story that has remained with me. After all the tests came back showing a negative drug screen, the doctors were puzzled and believed that perhaps her mother had been right all along and it was simply the effects of a severe panic attack. No such luck. I checked with the doctors after seeing my next patient and was informed that the CAT scan on this young girl had revealed a brain tumor. Though my job is only to perform psychiatric evaluations on these patients and arrange for their treatment, I had spent a great deal of time with this teenage girl and her mother during that night. Before I left the hospital that morning, I found her mother, panicked and tearful. This time, I laid my hand gently on the shoulder of this woman, knowing that no amount of reassurance or comfort could calm her. But in the darkness of that night, she pleadingly looked in my eyes, hoping for something I could not offer. And so I offered what I could, a gentle hand and prayers that have continued every day since that night.

It is events such as these, completely unexpected and yet touching so deeply to the core of who I am as a human being. It is events such as these, and so many others, that leave my face tear-streaked in those early morning hours. Yet it is the same events that bring to me an incredible reminder…this is part of my purpose and my meaning in this life. And that feels better than any words can describe.