Each time I visit the Red Cross, I surrender two units of packed red blood cells and am met with the assurance that with each donation, lives are saved. The cynic in me had pictured a freezer-burned bag of my cells tossed in biohazard garbage, but despite my pessimism, or perhaps directly because of it, the Red Cross accepts each unit with much fanfare. T-shirts, gift cards, and trinkets are presented as rewards, but faced with a critical shortage, they seem to have focused on the notion of confronting the cynics like me with the reality of the need.
Last year, as a part of this initiative, the Red Cross sent a notification via email of the arrival of my blood at the same hospital where the rest of my cells were recently employed as a medical student on a trauma surgery rotation. At first, I thought little of it—I had donated with the hopes that it would be used, and I told myself that I would treat it with the same indifference that I would give to any other medication—but on rounds, that day when one of my patient’s CBC revealed asymptomatic anemia, a unit of blood was to be ordered and I suddenly felt uncomfortable.
The moment passed and the blood was ordered, but as the hours and days wore on, I viewed each infusion with an increasingly profound significance. With each unit, I felt sudden ownership that was thrust upon me. A degree of responsibility that I seldom felt as a medical student. That was my blood that hung at the bedpost of a hemophiliac, my blood that was slammed through a rapid transfuser in the heat of a trauma activation, and my blood on the floor as I surveyed the wreckage of a cold body.
Over the coming days, I acutely felt the haunting dread that followed each decision I recommended. How would I feel if one of these patients had an adverse reaction to my blood—to the piece of myself that I gave only in good faith. I had tacitly relinquished the control of the blood I donated, but when it came to the final act, I was unsure of the implications. This was far from my norm where I would put in my time and blithely fulfill my duties. In the space of an infusion, I would cede a piece of myself and gain a tangible stake in the fate of another that would transcend duty hours and receive no tangible recompense.
To be responsible for their fate in ways more direct than any I had yet experienced tormented me at first, but in the eye of this storm, I realized that it was not a sensation that was totally foreign to me. This was the same sensation I felt when I woke up in the middle of the night worrying about how a patient was faring post-operatively or returned to a bedside long after my shift had ended. As I grew as a student-doctor I saw past the tangible part of myself I had given and began to see the ever more substantial stains of blood that invisibly covered the hearts of so many in that hospital.
I looked around at the physicians I was with and finally realized that my pain was also their pain. I saw for the first time the reality of their continuous sacrifice. I saw at that moment, the emotional scars they bore from the pieces they had given of themselves. Some were as old as their medical school training, and many more were fresher still. Since that experience, not a day has gone by where I don’t try to recapture the essence of that feeling. For each patient I try to heal, there is a cost to be borne, but with that comes an incomparable connection. I see clearly now how continuously tapping this reservoir can leave one immobilized by compassion fatigue, but I also begin to appreciate the true nobility of building a body of work that exists solely of the pieces that you give of yourself. There is meaning in this pain, and with the appreciation of connection my blood brought me, I have begun to believe that the tragic beauty of medicine is measured not in the volume of care that we give, but the pain we feel for each drop of blood that we leave on the floor.
Reprinted with permission from The NMA Advocate.
