I’ll admit it: I often dread working in the acute side of the ED, as I mentioned in a previous post. Not because I’m scared of traumas or the high-stakes intensity; in fact, it's the exact opposite. I actually thrive in chaos. But I just really, really hate the dynamic of scribing over there. If you’re curious about that, see "Under an Hour." That’s why, when I swapped shifts with another scribe and found myself scheduled for an A-side shift, I was a little less than thrilled. But hey, I figured, "Let's get it over with." Little did I know, that shift would be the one that gave me something to really write about.
Enter: My first trauma code. Just kidding. I’ve seen my fair share of traumas in my short time working in the ED. Most were pretty heart-wrenching, life-altering events that I’ll get around to writing about someday. This time was different because it was my first trauma code run by a trauma surgeon... who was having a moment.
It started like any other uneventful morning. I clocked in at 7 a.m., eyes still puffy from sleep, mentally preparing myself for whatever the day would throw at me. Then, the red phone rang. A red trauma, seven minutes out. An 80-year-old woman, involved in a motor vehicle accident. Unknown mechanism of collision. Now, in case Grey’s Anatomy misled you, ED doctors usually get a heads-up when a trauma is coming in, so they can prepare. EMS calls the charge nurse or attending to give basic details: age, sex, injury, vitals, stability, and—important detail whether it's a red code (serious) or a lesser color. This one was red, so we all geared up.
As the trauma team suited up in their PPE and lead aprons, I found my corner, ready to type furiously when the patient came in. She was airlifted in, so they rolled her in through the back door of the trauma bay. C-collar on, practically naked except for her underwear, with a few bloody scrapes on her arms and legs. Nothing too concerning at first glance. But then, a voice rang out from the foot of the bed:
“OKAY, WE'RE GONNA NEED SOME BETTER COMMUNICATION IF I'M GOING TO RUN THIS TRAUMA.”
Or something along the lines of that. It came out of nowhere. She was angry before the patient even rolled into the room, and it got me wondering... what did she see that I didn't see, that was being done wrong?
Anyways, I’m not going to get too hung up on her exact words. Honestly, I can’t remember them, because I was too busy processing how the entire room’s energy shifted. The team started to get visibly flustered and nervous in an environment already buzzing with tension. And I thought, “Wait, this is new. I’ve never seen anyone lose their cool in the ED.” Not that I have the wisdom of a charge nurse or an attending who's been in this place for years, but I’ve been in this job for a few months now and seen some pretty wild situations. This was the first time I saw a doctor, let alone a surgeon, lose their composure.
I get it, though. She was probably running on fumes, likely coming off a long night in the OR. I tried to put myself in her shoes. To ponder all the possibilities of things that could have been running through her mind. Maybe she was just about to walk out the door to go home when the call came in. Maybe she's been working for over 24 hours and hasn't seen her kids in what seems like days. Maybe she is dealing with a divorce at home or recently lost a family member. Maybe, and most probable given her attitude, she had just lost a patient and was trying her best not to lose another.
But, in all honesty, her approach really didn’t seem to do much to calm the situation. In fact, it made it worse. In my opinion, trauma codes run best when everyone’s focused and working as a unit. It’s almost like a well-choreographed dance: everyone knowing their role, communicating their moves, and keeping their eyes on the prize: saving the patient. But in this case? The focus seemed to shift from the patient to the surgeon’s orders, her barking critiques echoing through the room and making everyone roll their eyes. It took longer than it should have for them to start CPR, and the room felt more tense than necessary.
I want to give her the benefit of the doubt, though. I know how hard her job is. I know how exhausted she must have been. And what I really hope is that she was just having an off day. Maybe she isn't always like that. And I truly hope that, because in the moment, it didn't seem to come from a place of concern for the patient. It came across as her being power-hungry, her loving the orders as they barked out of her mouth, her reveling in the fear she inflicted in the team.
So, as much as I wanted to judge this surgeon for her less-than-stellar communication, I realized I was learning something invaluable. Trauma codes don’t just need brains; they need emotional smarts too. Leadership isn’t just about calling the shots; it’s about creating an environment where everyone is calm, cool, and collected enough to do their best work. After all, if you're barking orders like you're auditioning for a role in a medical drama, you might just end up with a team that's more focused on your performance than saving a life.
Lesson learned: In my future as a physician, I’ll be ready to be the leader who knows how to lead. Not just in my specialty, but in all those I come into contact with. And, maybe... just maybe, I'll bring a little zen to my first trauma code. Breathe in, breathe out, save lives. But for now, I’ll just stick to making sure my typing is up to snuff and leave the emotional leadership to the pros.
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