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Emergency Medicine News:
doi: 10.1097/01.EEM.0000446052.88994.d0
Second Opinion

Second Opinion: If These Walls Could Talk

Leap, Edwin MD

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Dr. Leapis a member of Blue Ridge Emergency Physicians, an emergency physician at Oconee Memorial Hospital in Seneca, SC, a member of the board of directors for the South Carolina College of Emergency Physicians, and an op-ed columnist for the Greenville News. He is also the author of three books, Working Knights, Cats Don't Hike, and The Practice Test, and of his own blog.

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A Southerner at heart, I find myself in love with places. We are forever pining for our family homes, our small town barbecue restaurant, the sound of some lake where catfish splash in the night, or the woods where our favorite tree-stand sits. Sometimes our afflictions for place become the stuff of novels: Scarlett O'Hara is always associated with her beloved Tara just as Faulkner is infused into Mississippi.

I will always remember the way daffodils broke through the snow beneath the enormous maples that lined the property at my paternal grandmother's house. We called them jonquils, not daffodils, and that place is deeply ingrained in my memory. And summer for my wife and me is now inextricably linked with the South Carolina beaches where we vacation with the children.

Place also has to do with hospitals in my life. They have character that is made up of physicians and nurses, patients and administrators and support staff, but it also has to do with the rooms and walls, the hallways, and even the location of those places where we work, day in and day out, night after night.

I first realized this love of hospitals as places worth wandering when I was in medical school. The old medical school at West Virginia University was a place of tiles and institutional paint with less light than newer places. Situated on a hilltop (like everything else there), the vistas were lovely when one had time to look. It has since become a perfectly wonderful office building, but it was the place where I did my first clinical rotations, and it is embedded in my psyche. It calls up wonder and excitement and anxiety to think of the blue and gray and to recall the feel of steam-heat on snowy days. Midway through my third year, we moved into Ruby Memorial Hospital, bright and cheery, with larger windows and spacious work areas; it was wonderful.

Oconee Medical Center was barely visible behind a beautiful pine forest when I first came to South Carolina to work. In fact, it was so heavily forested that the grounds supported a thriving population of deer and turkey, which could often be seen at night when I drove to work. Occasionally, a bear made its home there, only to be removed by the Department of Natural Resources. (Considering some of the more difficult ED clientele, I'd have traded the bear in a heartbeat.)

In those first years, before renovation, it was clear to me that I was a latecomer to an old facility that had seen a lot. The hallways and patient rooms had the sort of tiles that spoke of earlier times. Photos of the venerable doctors who had built the place over the decades lined the hallways. Professional and gray-headed, their lined eyes had seen so much in those old hallways; life and death, hope and despair. It was in the older labor and delivery rooms that my first two children were born; how many children entered the world there I can't imagine. It was in the old ED that I was first baptized by fire after residency, a young physician adding my story to a place that was so much older than me. I loved walking those halls, to codes, to medical records, to the cafeteria. They felt haunted but not in a frightening way. (Southerners often see the world as haunted by spirits, by the way.) Finally, it was there and in the newer version that I realized after our fourth and final child that those would probably be the last happy visits we would make to any hospital. Time proved me right on many levels.

I've wandered the halls of other hospitals, like St. Vincent's Hospital in Winchester, IN, where inspirational words and art decked the walls. I loved the quiet of that tiny place, night or day, and the way that crucifixes appeared everywhere. It is a great comfort to see that reminder of my sustaining faith interwoven with my profession.

I loved the way the cafeteria at Memorial Hospital and Health Care Center in Jasper, IN, had a fireplace. I loved how the code cart had a prayer card to be read at the death of a patient. I saw that after my first cardiac arrest, an unsuccessful effort, and the room then seemed warmer to me, less hopeless. A place should have some hope, even in darkness. It is the essence of a hospital, it seems.

Weather also affects a hospital. I've enjoyed the chance to walk the halls at night as the snow blows past lights outside, landing on statues of saints or cars. The sky is vast at the Memorial Hospital in Craig, CO, and I can see the storms move across the mountains, ripe with snow. That weather makes more poignant the photos of pioneers on the walls there, a reminder that even a small hospital is a huge advance over the days of old when brave men and women suffered with little to no care.

I lately came full circle. I worked in North Greenville Hospital, two counties over from my home. It is old, and the rooms are small and oddly arranged, but it's wonderfully snug and functional, and delight of delights, two of the patient rooms are former surgery suites with the ancient tile walls and floors of my medical school. The place has character and is frequented by characters, and it's essential to that little community.

I am ever in love with the idea of place. I anchor myself to geography and to the layout of the places. I try my best to remember from place to place, town to town, where everything is. I don't play computer games much or do puzzles, but this endless fascination with locale exercises my mind well enough.

Ultimately, it adds my presence, my memory, my ghost, if you will, to the many rooms and hallways where I have worked and wandered. That's a great gift to a romantic like me.

I hope that you can find love for the places and buildings where you work. Every place, like every patient, is an endless encyclopedia of stories waiting to be uncovered or made, waiting for you to insert yourself. Alfred Lord Tennyson, in Ulysses, said, “I am a part of all that I have met,” and no place is it truer than in our hospitals.

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