Eight years ago I graduated from my emergency medicine residency at Methodist Hospital of Indiana. At the time, I was ready to leave. I was well trained, tired of education, and anxious to improve my income. I needed a change of scenery. It was time to leave the hospital and the town. Time to buy a house and leave the apartment my wife and I called home. But in our move, I left more than a location, more than a job, more than a training program. Most painfully, I left a group of people who were my family.
Consequently, when I returned in April for the 25th anniversary reunion of the Methodist Hospital Emergency Medicine Residency Program (now called the Indiana University School of Medicine/Emergency Medicine Residency at Clarian/Methodist Hospital, a mouthful to be sure), I still felt that I was coming home. From the time I entered the reunion hotel, I was looking and listening for faces and voices from my training. And I found them.
I found them in the hospital at research day lectures, in the hotel lobby and restaurant. And most wonderful of all, at the reception, dinner, and presentations that were the focal points of the weekend.
I rediscovered the confident faces of my instructors. As I shook their hands and laughed with them, I realized how much each had molded me. I remembered which ones I looked to as role models, and which ones challenged me. I wish that there had been time and an opportunity to thank each one for the dedication, knowledge, and most of all the humanity they showed me every day of my tenure in that place. They taught me more than the science of medicine. They taught me how to tell sick from not sick. And how to be an island of calm in the storm because that is how I saw them.
Those faces and voices from the past, their presence at the residency reunion was a sweet thing
I sat and laughed with nurses, secretaries, and others who were so much our co-conspirators, our fellow travelers through the years. Theirs was a difficult challenge; befriend a group of strangers and say goodbye to a band of close friends every year. And yet we had a closeness seldom seen between physicians-in-training and non-physician staff. They gave us their trust and their protection, their secrets and their hearts. And they are as much a part of those wonderful memories as anyone else we knew.
I saw the faces of other former residents, many of whom I had not seen since I left. And because we were so few, because we were together so much, I recall those faces in many situations. I recall them intently caring for patients, sometimes pulling a helicopter stretcher down a white corridor, looking nervously at the cardiac monitor of some unfortunate patient transported from another part of the state. Helmet in hand, stethoscope slung across their necks, sometimes with blood-soaked gloves and mud caked boots, they looked like they had flown in from battle. We were all in our youthful glory in those days as we saved some and lost others. Teddy Roosevelt said in every life there should be at least one “crowded hour,” like his charge up San Juan Hill. I think that as residents, we shared crowded years.
But rather than belabor the image so loved by television viewers, I also recall those faces laughing until tears streamed down their faces at jokes told in lecture or pranks played on classmates. I remember parties when the strain of work was washed away in the cool, healing stream of friends' laughter. Times when we instituted our own form of critical stress debriefing, sometimes lubricated with alcohol, colluding with one another over difficulties, sharing gossip, agreeing that we would have done the same thing to this or that patient, telling our friends not to worry. We saw ourselves as an elite team, which we were. We dreamed about the end, ignoring the fact that it would mean separation.
I look back and I see faces intent on learning; I see lecture halls full of men and women whose minds were so sharp, skills so precise that I often felt I had wandered into the wrong room and would be asked to leave at any moment. “No, no, no. Janitor orientation is down the hall, Mr. Leap.” I loved them for their minds and their potential. I felt privileged to be counted among their ranks. I hoped I could be as bright as my staff, my classmates, and those ahead and behind me.
In my mind's eye, I also see their faces weary and troubled. I remember them collapsed on the brown couch that remains to this day in the residents' lounge. I remember their eyes red, clothes wrinkled from being up all night and sleeping for short periods in uncomfortable chairs. I remember their anger at unfair treatment, their frustration with spending too much time on the job. I remember their occasional tears for the sadness that daily surrounds a busy emergency department. My memory takes me back to personal crises we all experienced, as our lives were swept up in the cyclonic forces of exhaustion and failure, elation and triumph. Sometimes we coped well; sometimes we did not. But we survived an experience that no one in our society at large can understand without having been there.
I cannot think about those faces, cannot hear those voices in the recesses of my mind without smiling. I was blessed to be with all of them. Though not every residency in the world is like mine was, every one should be. For all of the difficulty of residency training, there should be a compensation that is concurrent, a balance of delight against the weight of hardship. The promise of money or prestige after graduation is grossly insufficient. Only the love of friend for friend is an adequate counterpoint.
Though I recall those faces and voices from the past, their presence at the reunion in the blessed present was a sweet thing. There have been trials among our ranks. There have been tragedies and loss, divorces and marriages, and the incalculable wonder of children born to and adopted by those exceptional men and women. Their laughter and their dancing eyes give me cause for thanks, that they are well, and still in love with this life. I hope they all live to one hundred years, and beyond.
You see, after I left the reunion, I realized that the way I felt reminded me of my images of heaven. I've always envisioned heaven as a place of endless, perfect fellowship with the ones we love. A place where a conversation begun on earth may begin again and last for the timeless equivalent of a thousand years. A place where every moment is filled with the same satisfied feeling one has after eating a wonderful meal, having a glass of wine, and travelling around a great room from friend to friend, embracing and talking. I think it will be like that. And if it is, I want to continue the residency reunion on the far shores. Because I have a lot more thanks to give, a lot more stories to share, and an eternity of affection for all those I hold so dear.