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Artist’s Statement: Violet: Humanism Amidst Critical Illness

Elfassy, Michael D. MD, MSc; Simpson, Jory S. MD, MEd, FRCSC

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doi: 10.1097/ACM.0000000000003525
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“Violet? Can you hear me? Can you open your eyes?”

Purple eye shadow draped over her eyelids, concealing her pupils but illuminating a reality more profound.

It is a cold winter morning—the first overnight shift of my general surgery rotation as a clinical clerk. Suddenly, I am awoken to a page for a trauma. I rush to the trauma bay with a flood of emotions: fear, excitement, and anticipation. Standing at the foot of the bed, I am tasked with documenting the primary and secondary surveys, while the trauma team is scrambling around me to resuscitate the patient. Soon after, Violet is rushed to the operating room and prepped from head to toe. I scrub in for the trauma laparotomy with my team. Simultaneously, other surgical services work on several open fractures. The urgency is palpable, and I do what I can to contribute amidst the chaos. Several hours later, Violet is stabilized and sent to the intensive care unit (ICU) for monitoring.

The stillness of the call room upon my return is paradoxically deafening. Slowly, the adrenaline subsides, and the racing beat of my heart is replaced by the racing thoughts in my head. At this moment, I realize that despite knowing intricate details of Violet’s condition, I did not fully appreciate the person who experienced the trauma. In the trauma bay and operating room, I was primarily focused on the physiology and anatomy pertaining to Violet’s injuries. In the silence, I cannot help but wonder about Violet and what her life was like before it suddenly changed forever.

Violet inspired me to draw Violet, on the cover of this issue. She can be seen in the ICU, sedated and intubated. Despite experiencing major traumatic injuries, along with frequent surgeries and invasive procedures, her purple eye shadow and nail polish remained intact several weeks following the event. The purple that pierces through the black-and-white portrait represents the contrast between the routine care of critical illness, and the resilient identity of a person. Veiled in standard inpatient attire, the purple acts as the last remaining expressive piece of individuality. It is a powerful reminder that we are treating a person and not just a “polytrauma in Bed 8.” Although I had not met Violet before, her personality shined through her vibrant, chipped nail polish.

Without humanism, medical and surgical management becomes a routine task, another day at work. How can we really save lives if we have lost the ability to see life beyond the surgical field? If a whole person becomes limited to vital signs and critical laboratory values, we have lost the reason why providing care truly matters: the aspiring musician who may never get the chance to perform; the loved one in the waiting room who anxiously awaits the outcome; the baby at home who may never know a life with her mother. Humanism is the inspiration behind medicine. The drive in the middle of the night that keeps your mental acuity sharp, and the reminder that we must advocate for individuals who may be unable to advocate for themselves.

Violet never heard me. She never opened her eyes. But she colored my perspective by teaching me a lesson I will never forget: the importance of humanism.

Violet
Copyright © 2020 by the Association of American Medical Colleges