by Seth Thomas, MD
July 2024
I’ve never been much of a runner. The furthest I ran before college was maybe 5 miles, and I can count on one hand how many times I went for a jog in medical school. I grew up spending long days hiking through the Rockies in Colorado while I was a kid, and was happy to take it slow and stroll through shady forests and big green meadows. I’ve been decently fit but always found the long stretches of silence and repetitiveness of running monotonous compared to the other pursuits the mountains had to offer. Recently I’ve had quite a change of heart. During my last few months of residency, I have run further and more often than in any other period of my life.
Late on a weeknight evening towards the end of my intern year I was working in our trauma bay with a senior resident. The day had been relatively quiet, the few sick patients that were brought to us by EMS were quickly admitted and shipped off to other parts of the hospital. It was an unusual and welcome reprieve. We relished the chance to chat during our shift, and the senior resident’s excitement for his impending graduation and his new life outside of residency dominated much of the conversation. Where he was going to live, his new job and plans for vacations. Eventually, he became more reflective and we talked of residents who had long since graduated, and his first experiences as a scared intern in the trauma bay.
In the last hour of our shift things started to heat up. With about 20 minutes left we received a notice from our dispatch center that an elderly male with a gun shot wound to the head, likely self-inflicted, was being brought in. Our large trauma bay quickly flooded with bodies, trauma and neurosurgeons, techs and nurses, too many hands to count all prepping a room that was already overflowing with voices. My senior resident floated through the crowd to stand next to me at the head of the bed. I had intubated in the ED a few times as an intern but had never been faced with a sick trauma patient who I knew likely needed intubation soon after arrival. My senior resident quickly uttered a few words of advice before the ambulance came wailing into the bay. “Everyone else is going to be running around, grabbing this or that, getting lines set up, whatever. Not you. You’re locked into the head of the bed until the tube is confirmed on x-ray.”
I had worn the same pair of soft-topped sneakers every day of residency so far. They were comfortable, with thick foam soles and a breathable upper mesh.They were great for the few times I jogged a mile or two in my neighborhood, and most importantly, they were machine washable. This was a real benefit the handful of times I had blood or other unsavory fluids splash off a gurney during a lac repair or I&D. As an intern there were usually 3 rows of bodies between me and whatever interesting procedure might have been happening, so the opportunity for them to get soiled was pretty rare. I was wearing them that night as I nervously shifted my weight from foot to foot while organizing my airway equipment.
Our patient rolled in and looked surprisingly well, all things considered. He was managing to breathe on his own despite missing large parts of his skull. The volume of the trauma bay faded away as we set up to intubate. As we repositioned him higher up in our gurney, a liter of clotted blood spilled out from behing the bandages placed by EMS. My legs were splashed from the knees down and I felt my toes squish in my shoes as I passed the tube. Before I knew it the tube was secured and confirmed, and the pt was whisked away. My shift was over.
As I was finishing up notes I commented to my senior how little time I had to decontaminate my shoes before the next shift. Or if I even wanted to keep them, for that matter. He pointed down to his own shoes, fully waterproof trail runners with rugged soles. Even though he wasn’t much of a runner himself, he told me these shoes were great for an easy and quick rinse or wipe down on shift.
For the last few months I’ve been trying to fit into my new shoes. Sleek, waterproof, bought second-hand but not in bad shape. I started running more, to see if it felt differently now. The long views and hours full of silence are a welcome change after a shift full of constant buzz. Sometimes my mind wanders back to my patient that night, wondering what was torturing him so terribly that he had no other means of relief. On a long quiet run almost a week later I remembered EMS saying his wife had called 911 from downstairs. What had stopped him from reaching out when he had someone so close? I didn’t find any satisfying answers for the rest of my run, but slowly my thoughts of that night started to become muted. By the time I had turned back to the trailhead, I was thoughtlessly enjoying the views of a pink sunset and the low buzz of insects.
As a new second year, there’s no longer an option to watch on the sidelines. I’m at the head of the bed more often now, and more of the responsibility of the department is on me. There are days that go well and days that stretch on forever and leave me exhausted and filthy by the end of them.
I’m hoping that the miles get easier, and each day I slip on my new shoes and keep running.