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Emergency Medicine News:
doi: 10.1097/01.EEM.0000419513.27855.c4
Breaking News

Breaking News: Nurse Beats ED Stress. By Writing Simple Haiku. Some Funny, Some Sad.

Scheck, Anne

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Of all the books about emergency medicine ever written, from medical texts found on library shelves to the biographies and novels that seem to spawn television dramas, not a single anthology of poems has celebrated the profession in all its gory glory.

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Until now.

Meet Jason Hautala, LDN, the unofficial poet-in-residence in the emergency department of Mason General Hospital in rural Shelton, WA, whose verses of haiku — now recorded in his recently published book, Haiku STAT! — are inspired by projectile vomiting, massive flatulence, and attack-prone patients.

Odes wax poetic to cases such as a “Code Brown,” a reference involving a physical act that's all too easy to infer, and Mr. Hautala offers a cynical view of life in the ED, right alongside a more sentimental one. A sampling:

Helping people die.

Enemas and Foley caths.

Things I've been thanked for.

And:

Coding Santa Claus.

Went down in a shopping mall.

He's not immortal.

Shaggy-haired and soft-spoken, Mr. Hautala not only appears the very picture of someone who would pen poetry, he has a history that would seem ample preparation for it: a past Peace Corps volunteer, a military veteran, a man who studied zoology before he became a nurse. Calling him “unusually bright” and “creative,” medical director Dean Gushee, MD, noted the haiku-writing seems to answer the same need as his own passion for wildlife photography. Dr. Gushee has turned his lens on animals all over the world, despite the fact that, even in the ED, he is surrounded by nature; a wood with towering firs abuts the hospital grounds and parts of the town look like a setting for Field and Stream. (See FastLinks.)

Getting outside the ED, mentally and physically, can be essential. “The outlets physicians use to combat stress are as varied as the physicians themselves, and range from outdoor activities such as hiking and mountain climbing to swimming to journaling,” said Stephen Davis, MPA, MSW, the director of clinical research at West Virginia University's ED in Morgantown, who has researched how burnout can be reduced by writing. “The outlets physicians use to combat stress are as varied as the physicians themselves, and range from outdoor activities such as hiking and mountain climbing to swimming to journaling,” said Stephen Davis, MPA, MSW, the director of clinical research at West Virginia University's ED in Morgantown.

The ED can swamp the emotions of health care providers with high sensitivity. Yet they are the very people that a growing cohort of medical administrators says are most needed, as medical school admissions committees struggle to find a way to connect measures of emotional intelligence to other performance tests, such as MCAT scores. (Med Educ 2009;43[11]:1069.) And there is now increasing emphasis on keeping such people in the field, by finding outlets for their “reflective capacity,” as it is becoming known. (Acad Med 2012;87[1]:41.)

“I turned toward haiku as a way to vent my frustrations,” Mr. Hautala explained, adding that the idea for the book started after his inaugural efforts were nixed for the hospital newsletter. “I wanted to be able to vent on some of the typical frustrations that we experience every day, such as people with high pain tolerances who cry because the blood pressure cuff is too tight,” as well as some haunting experiences that seem unshakable — the kid high on meth denying it, the mom who dies, the 13-year-old who says she has no sexual experience but is pregnant just the same.

“All of the haiku in the book are real stories, and many of them, while presented in a funny way, were really quite painful to deal with at the time,” he said.

Mr. Hautala can formulate haiku almost instantly, as he demonstrated during the uncharacteristic silence on Super Bowl Sunday, when he offered a tour of the hospital on the condition that it could not be called “quiet” because “we are superstitious about that.” His ED sees more than 20,000 patients per year, but on that day, the ambulance line, which belts out the theme song to “Mission: Impossible,” never sounded.

Mr. Hautala has the uncanny ability to produce haiku on the spot. Some, like an ode to not having time for a bathroom break, prompt his brother, emergency physician John Hautala, MD, to misinform visitors that Mr. Hautala is adopted.

“Yes, I frequently tell people at work that Jason was adopted. His sense of humor is more warped than most,” explained Dr. Hautala. “It has gotten to the point that when I hear him making one of his comments, usually by the groans of the people who have just heard it, I shout out the word ‘adopted’ at work.” That always gets another round of laughs, Dr. Hautala said.

If Mr. Hautala's observations make him a cherished jester among the staff, where he is reportedly “beloved” and found “funny when it counts most,” he is also providing a look at something that is being appreciated more in medicine: the role of humor in stress reduction.

“Who else can be abused so often, be exposed to such awful things, day after day, and keep coming back, just for the satisfaction of helping those few who really need our help during their worst day?” asked Mr. Hautala. The answer is “the most caring people you ever meet,” he said.

A little sarcasm and irony can go a long way to assist in coping. That's one reason some of the terms in the glossary of his book represent a combined effort, from scenarios only an ED staffer can understand. “Psychosocial dystrophy,” for instance, is partly defined as “a complete inability to control one's emotions, thoughts, and actions,” which, if it ever becomes a billable category, “will be the number-one diagnosis in the ER.” A mucus plug is dubbed an “icky OB term” that is pretty much self-explanatory.

Mr. Hautala started writing verse prolifically after his wife, Andrea, who used to be a nurse in the intensive care unit, left the profession to start a photography business. “We used to be able to talk about work things over dinner,” he said. “But after quitting the nursing profession, she quickly became a ‘normal’ person, and no longer appreciates stories of projectile vomiting over dinner, for some reason,” Mr. Hautala noted.

It may be a while before a second book of haiku is printed, Mr. Hautala said. He would like to provide medical care internationally in the near future; currently, the ED is holding a $10-a-ticket raffle for his medical mission to Cambodia this summer. The prize: giving the haiku scribe a haircut. “The winner of the raffle gets to cut his hair however he would like,” Dr. Hautala explained, adding that his younger brother is sure to lose many of his locks. “The current favorites are the ‘Benedictine Monk look’ or to simply shave one side of his head,” said Dr. Hautala. “I bought 10 tickets right away,” Dr. Hautala added. “Wish me luck!”

Click and Connect! Access the links in EMN by reading this issue on our website or in our iPad app, both available on www.EM-News.com.

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FastLinks

* Mr. Hautula's book of haiku is available for $14.99 at haikustat.com.

* Dr. Gushee's website, www.deangushee.com, features galleries of his wildlife photography.

* Comments about this article? Write to EMN at emn@lww.com.

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