A Note From The ER

Since I don’t really write nor overly care about current events I’m gonna postpone what I was gonna write about this week and thank you in advance for indulging something a bit off-the-cuff and personal.

The last 2 months my family Whatsapp chat has been an emergency room on a full moon night. No less than 6 surgeries or hospitalizations ranging from an eye surgery on a 6-year old to my 85 yr old grandmother’s emergency hip surgery this week. This is close family. Every person shares 1/4 to 1/2 my dna (this expression is probably not biologically true but just as we gloss over misspelled words, you can identify what relations this refers to almost perfectly). It’s been a bit of bad luck clustered around the start of 2020.

On Friday, I called my house shortly after getting to work. I wanted an update from my mother-in-law on Zak’s fever. He was home from school Thursday and Friday. Turns out he was still asleep at 8am, but now Max (3.5 yrs old) was sick. With Yinh just getting ready to return from Japan, I was calling the workday early and heading home to pitch in. When I got home Zak was awake and on the mend but now Max was pathetic and clearly having a rough go of it. Earlier in the week, his preschool closed for 2 days because all the teachers got strep. It was an easy decision to take him to the pediatrician for some antibiotics.

At the doctor’s office, they run some tests and see he also has flu ‘A’. We didn’t do flu shots for the kids. Bad us. And since his breathing is a bit strained we head home with albuterol as well as antibiotics and Tamiflu. Parents will relate.

At home the Tamiflu makes him vomit but even more annoying is the nebulizer sessions don’t seem to slow down his rapid breathing. I call the after-hours line and the doctor on-call tells me to count his breaths in one minute. Around 60. At 50 or more she’d recommend going to the ER. So we pack a bag and off we go to John Muir in Walnut Creek. Now there isn’t going to be a scary reveal otherwise I wouldn’t write about it, so let’s diffuse that now. However, his chest x-ray shows budding pneumonia as well.

While he’s battling on 3 fronts, he is doing well. They administer oxygen and IV. Standard stuff. Parents of kids with asthma can double relate. He’s responsive to the treatments. But all things considered, we are staying the night. Actually, at least 2 nights and as I write this I’m not sure if there will be more. The ordeal started Friday so it will take a few days to peak and since pneumonia might be viral the antibiotics can’t kill two birds with one stone as they are already indicated for strep. By staying in the hospital, his immune system can get some extra support. He’s doing fine and just needs time.

Takeaways

As you can imagine, this is a very long day. And from the moment we checked into the ER until we were in our room for the night it was about 4 hours. There was a lot of downtime in that period. A few hopefully constructive takeaways:

1) Find a positive angle 

When I texted Yinh that I was in the ER I knew she wouldn’t open the texts until she landed for her layover in Japan. No matter how unalarming I write this text, the facts of the matter are going to induce panic. While the parent that’s present has to make realtime decisions and actually deal with logistics, the parent thousands of miles away, in my opinion, is in a worse emotional situation. She feels helpless and there is no amount of female empowerment that can suppress “working mom guilt” in a moment like that. I have the benefit of seeing that Max seems to be doing ok which is hard to believe when you are across the world and hear he has strep, flu, and pneumonia. I also have the advantage of seeing the staff’s composure and methods firsthand. I can see their reassurances firsthand and enjoy the impression that they are in control. My words, no matter how calm, are not going to stop her otherwise routine-ish flight from being the longest one of her life.

Lesson

I only needed to imagine being in her shoes to reframe the ordeal as one in which I was thankful to be present. I felt fortunate to have the role I was dealt which sure beats self-pity or any other useless emotion. Every bit of uplifting perspective you can seize during emergencies is worth striving for.

2) Bedside Manner

The care at John Muir from the nurses, to the pediatrician they called in, to the overnight doctors on the peds floor was outstanding. As far as tactics, transparency, and explanations they seemed supremely competent. I felt Max is in great hands. But that feeling comes from more than competence. It’s the way they present themselves. The bedside manner. I feel invited into the process but more as a board member. While I have ultimate say, it’s clear that the folks in the trenches know what’s best. Despite that, they are never arrogant or dismissive of my thoughts yet also firm about what is called for. Combine this with the composure and even-handedness that they exhibit and it’s a masterclass in communication.

Lesson

Crisis or simple brushfire, when dealing with non-experts, mind your bedside manners. Be a pro. How would an ER doctor act?

3) Focus

With a long weekend coming up and no travel plans, we were looking forward to a hike with friends, some downtime, and a chance to cross some chores off the list. Max had other plans. From the moment you decide you are going to the time warp known as the ER, you know your plans are over. More than that, all external stimuli fade to the background. The contrast is unreal. Chat messages, your reading queue, obligations, and whatever you were kind of working on in your brain’s standby mode simply fades to grey. The only thing in bold colors is the task at hand — get Max what he needs. It’s a very focusing experience. Circumstances aside for a moment. It was a state of presence I felt good in. I don’t think it’s quite the same “flow” that silent-mode advocates strive for. It’s almost the sense that nothing but what’s in front me matters. It’s the same feeling I had the day my kids were born. I think it’s a healthy feeling but it might also be irresponsible or nihlistic. I suspect that people who climb or surf big waves have found a way to bottle it. Interested in your thoughts on this.

Lesson

Your “presence” capacity has headroom. Find ways to access it.

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