There is a solidarity among groups of people who work in similar roles, even if they work in different places.  Empathy comes easier when you have already walked several miles in similar shoes, and it seems natural to celebrate the victories of one as a triumph for all.  It was, therefore, with a swell of pride that I recently learned of a study at one hospital which found that, when compared to other specialties, medical personnel within the ED had the largest bladders.  Go, Team!

While flattered, I am not surprised by this prestigious designation.  There are many mantras in our ED, but I think the general vibe can best be summed up by the affirmation, “I can hold it.”  I have worked beside and learned from some tremendously strong and selfless people on the front lines of medicine.  They hold it together.  They hold each other up.  They hold their tongues.  They hold to their training.  They hold pressure.  They hold hands.  And when potty breaks are a luxury that they can’t afford, they just plain hold it.  They think under pressure, show grace under fire, and carry heavy loads with poise and stamina.  

But no one can hold it forever.  All great leaders have had a place to escape for solitude, silence, and refreshment–a place to unload and to refuel.  Jesus had a mountainside.  Harry Potter had the Room of Requirement.  We have Bed Nineteen.

Bed Nineteen is our negative pressure ventilation room.  Its official purpose is to be a place to put patients if we are concerned about super contagious airborne pathogens like TB, but its off-label use is much more consistently helpful.  Because of its negative pressure, Bed Nineteen is essentially soundproof.  Also, it is the only room in the ED that has an attached bathroom that can only be accessed through the room.  Therefore, it is the only place in the ED where you can be two full doors away from anyone else.  Its benefits are especially high-yield on days when there are tacos or bean soup in the cafeteria, but it is a benevolent space, no matter what we are unloading.  It’s a great place to privately UpToDate something you know you should already know, or do a happy dance that your last shift before vacation is two hours away from being done, or pray for another person you just diagnosed with cancer.  Bed Nineteen is important because silence and solitude and self-awareness are important, even in small amounts.  We all function better when we know we have a quiet space available, even if we can probably hold it anyway.

Over the next few months, our band is breaking up, as many of the providers who taught me their craft over the past few years are chasing wonderful new opportunities.  My prayer for my friends is that they find the Bed Nineteens in their new departments, and that their teams rally around to hold them up–I know they will do the same for their new teams.  It is difficult to describe the graceful way these Men and Women handle the stress and chaos of their work–the ED is a bit of a jungle.  Fortunately, there is a jungle expert, Jungle Book author Rudyard Kipling, who describes it quite well.  Thanks for your example, and thank you for making it easy to, in the words of King Louie, “wanna be like you.”

 

If–by Rudyard Kipling

 

If you can keep your head when all about you   

Are losing theirs and blaming it on you,   

If you can trust yourself when all men doubt you,

But make allowance for their doubting too;   

If you can wait and not be tired by waiting,

Or being lied about, don’t deal in lies,

Or being hated, don’t give way to hating,

And yet don’t look too good, nor talk too wise:

 

If you can dream—and not make dreams your master;   

If you can think—and not make thoughts your aim;   

If you can meet with Triumph and Disaster

And treat those two impostors just the same;   

If you can bear to hear the truth you’ve spoken

Twisted by knaves to make a trap for fools,

Or watch the things you gave your life to, broken,

And stoop and build ’em up with worn-out tools:

 

If you can make one heap of all your winnings

And risk it on one turn of pitch-and-toss,

And lose, and start again at your beginnings

And never breathe a word about your loss;

If you can force your heart and nerve and sinew

To serve your turn long after they are gone,   

And so hold on when there is nothing in you

Except the Will which says to them: ‘Hold on!’

 

If you can talk with crowds and keep your virtue,   

Or walk with Kings—nor lose the common touch,

If neither foes nor loving friends can hurt you,

If all men count with you, but none too much;

If you can fill the unforgiving minute

With sixty seconds’ worth of distance run,   

Yours is the Earth and everything that’s in it,   

And—which is more—you’ll be a Man, my son!