Volume 10

February - 2020

Cover: Fall in New Hampshire

I painted this as a gift in 2018. It features Lake Winnisquam, at the end of the summer, when the leaves have just started to change. It has been an important place of solitude, to escape to after a string of busy shifts.

Letter from the Editors:

Can you believe that it has been ten volumes already? It has been such an honor and privilege to share the unique and creative talents of emergency professionals and in doing so promote their well-being. We are so excited to share this fully-loaded volume with the community! Inside you’ll find wonderful artwork, a gripping story, and our blogs first collaboration between artists! What are you waiting for? Scroll down!

Living in the ED

I focus my attention on the cheap, off-white 2x4 foot drop ceiling tiles to distract myself from the sharp pain of the needle digging into my arm. My brain is perseverating on the emergency department. I feel as if I never leave the hospital. Even during brief, blissful periods at home, I often dream of being confined in the blue-grey walls of the ED. My goals are to recover from events I’ve endured, horrors I’ve seen, and mistakes that might have been made along the way.

Being a patient strips people of their autonomy, their agency. Always overcrowded, with patients shoved into every corner, squeezed into every available crevice, docs and nurses must spend more time behind their computers than talking. Now that I’m here, I only add to the problem. There’s always more to say, but I know that no one has time to converse. No one has the time to hear what I’m really going through.

The piercing pain spreads along my forearm then dulls into a mild, constant burning sensation. It’s a feeling I’m never quite used to, but I can now anticipate that transition. Trying to relax, I take deep breaths. To distract myself, I envision the myriad faces and patients I’ve seen at the hospital. But my empathy envelops their pain, too. Even when I don’t want to, I carry other people’s struggles with me.

The pain transitions to adrenaline. My heart rate rises, my vision zeroing in on gloved, accomplished hands working smoothly at my side. My fingers twitch a bit as the nerve is stimulated. I think back to my hand balling into a fist, imagining that one day I wanted to strike a physician with whom I fought. But there’s no need to fight each other. It’s just the stress, the pressure-cooker of the ED, the suffering, the sleep deprivation – it gets to all of us, eventually.

There’s no rest in a hospital, no reprieve from the onslaught of human suffering. We’re overwhelmed. Exhausted. Stretched. A few drops of blood are wiped away. My arm is numb. We’re almost finished. Some pain and scars run deep, but instead of hiding them, I proudly wear mine on my sleeve. I fantasize of a future where I can regularly spend time at home, with my family, and not in the sterile confines of a hospital room. The gloved hand reaches for a bandage as I steel myself for what comes next.

When he’s done, it’s back to the hospital I go. For another shift, another day of being an ED resident, another day of wondering whether my actions resulted in the death of another human being. One with whom I’ll never have enough time to connect, never really know, but either way be tasked with telling the love of their life that they died. The vision I held, of connecting and helping and healing, is all but faded. Modern medicine is a dull slog, with more red tape than treatment, more charting than patient care. I chose this, I know I did, but I didn’t know, didn’t really know, what I was getting into. Which is why today, before my shift, I went to my favorite artist and added new ink to my arm. This tattoo is for my patients.

From the Author:

This is a fictional piece about a burnt out resident struggling with the reality of providing emergency care. Themes touched upon include the overcrowding of EDs, the impersonal nature of medicine today, and the unending time spent behind computers. I channeled my frustrations from residency into the piece. Overall, the reader will hopefully come away with a better understanding as to why EM residents and attendings are burning out at record rates.

Writing, even as a child, always gave me a safe space to vent, to process, and to deal with events in my life. As a physician, I continue to use writing as a way to share my experiences with patients and providers alike.

A study of ice and snow

This is one of the first studies of one hundred that Dhir compiled comparing snow and ice in the Polar regions.

Artist statement: There is a comforting silence that comes with a fresh snowfall (scientifically attributed to the porous characteristics of crystallized flakes that absorb soundwaves and minimize ambient sound). The rolling formation of curved lines from the snowbanks and silhouettes of trees blanketed in snow have a softer, free flowing, linear formation. This is contrasted with the crisp cool, and somewhat sharp essence that comes with slick glassy ice, where sound waves reflect off of hard cold surfaces, becoming more clearer the farther you travel away from the originating source. Frozen water evokes thoughts of a rigid harsh climate, brittle formations, and the landscapes are created with saw toothed, sharp straight lines and glassy reflections. Somewhere in between is an awareness and appreciation for nature’s hard and soft, light and heavy, the push and pull, and of course, the spark of excitement for an outdoor adventure. Human relationships, the ED environment, and the affects of the outdoors on our pathos balance and compliment these beautifully contrasting properties.

The Road Less Traveled

Duston Road

A woman stood alongside the road picking trash with a sharpened pole, dropping cans into the burlap sling across her back. She wore a straw hat and an orange vest; sun-taut skin, knotted like oak.

What are you doing? I asked.

I'm writing my obituary, she said.

There was no one around for miles. This road was seldom used, if not by me.

No one will see this, I said.

That doesn't matter, she replied, looking up at me in such a way that I felt small.

It will not matter. This I thought, but did not say.

I left her on the road and continued on my way. When I looked back, she was stooped to the ground, her hat level to the ground like a setting sun.

Later that night, I could not sleep, even after the third nightcap.

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From the Photographer: I was quite excited by the idea of doing a collaboration with another artist who has a completely different skill set than myself. I appreciated the glimpse into a similar, yet different creative mind, and the stories that can be drawn from one photo steeped within our past experiences and adventures.

Do you want to see your art shared with the community? Don’t forget to submit today!

Finally, don’t forget to share Art of Emergency Medicine with your colleagues, friends, and family on Twitter or Instagram and like us on Facebook for all the latest news!

This Months Featured Artists:

Andrew J. Park

Andrew Park is a fourth year medical student at the University of California, San Diego School of Medicine. He learned to write (painfully) as a history major at Dartmouth College. His medical interests include emergency medicine, addiction, and narrative medicine. He likes coffee, dislikes coffee stains. On days when his shoulder does not ache, he enjoys surfing and writing flash fiction. You can find more of his work and follow him on Twitter.

Bryn Dhir

Prior to medical school, Bryn Dhir double majored in Fine Art and Geography. Since that time, Bryn’s path has been filled with unscripted detours as an educator, environmentalist, leadership skills director, writer, explorer, research scientist, with a deep seeded passion for the rugged wilderness. Dedicated to emergency medicine and committed to vulnerable populations, Bryn believes that experiences and lessons learned on paths less traveled overlap; there is always something to learn from everyone and everything we encounter. Bryn’s art (watercolor, graphic, mixed media, photography) and interest across many disciplines captures a little bit of those moments.

Ellie Wallace, MD

I have been an amateur artist and crafter my entire life, now masquerading as an Emergency Medicine attending as my day job. I enjoy drawing, painting, sculpting, sewing, knitting, cooking, and trying new media all the time. Other interests include beaches, ice cream, skiing, and cat videos.

Stephanie Benjamin, MD

Physician in Emergency Medicine. Started painting as a challenge to myself. Started with watercolor, then progressed to acrylics and now playing with oils. I love everything creative including photography, writing, blogging, beading and quilting. Book excerpts, articles, satire, and more can be found at her website StephBenjaminMD.com.

Jonathan Warren, MD

A PGY-2 at Harbor-UCLA Medical Center and founder of Art of Emergency Medicine. His hobbies include photography, hiking, Netflix, and dogs. He’s always on the lookout for the next adventure. Find more of his photography on Instagram.

You can learn more about the artists featured in this and other volumes at our contributors page!