my hesitation...

i couldn't do it. i heard the pain in her voice, saw the grimace on her face and the tears roll down her face and I simply couldn't do it. this is a pivotal moment in anyones journey in medicine where you see that you are inflicting pain on someone else (for their benefit in the end of course) and you know you need to keep moving. finish the job.

but today was not my moment.
so I stopped the nerve block and let my mentor take over, while I held her hand, rubbed her arm and coached her to continue breathing.

I watched him drive the beveled needle into the top of her foot until he hit bone and then draw back a little and inject anesthetic on the way out. he injected one site, two, three, four, five...eight.... i lost count. i watched her skin swell around the injection site like water in a balloon. i watched as the drop of blood was pinched out of the puncture hole and roll down her foot. i watched and imagined how badly this must be hurting her....

will I be able to do this job? how on earth am I ever going to survive if I cannot hurt people? this is a necessary hurt- the kind that is needed to survive a surgery, or to stitch a large head lac, or to draw CSF from a young childs spinal canal to determine the cause of their illness. These are things that I need to be able to do, and do confidently.... yet everytime I hear a cry, or see squirming, or tears falling I start to falter- I hesitate and the confidence is lost. I feel their pain- literally. it makes me sick to my stomach.

today in surgery this same woman was complaining of pain in a very sedated, far off voice I could hear her say "that hurts". I felt her wiggle beneath my hands, and I began to worry that she was feeling every bit of this, every cut, every bone breaking, and the ligaments being cut. After several people reassured me that with the nerve block and the phentanyl it would be nearly impossible to feel any pain I started to relax. Finally it was my turn to advance a screw the size of a thin pencil into the tip of her toe with a power drill - and I made myself do it. I have a feeling this will be an ongoing battle for me. This feeling of hesitation may never go away...

maybe this is a bad/weak way to practice medicine- or maybe this is a wonderful grounded frame of mind? is a little hesitation so horrible?