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I Cannot Let These People Down

Judy Wong

At that moment, inside the intensive care unit (ICU), I felt like a baby salmon swimming alone in the Atlantic Ocean. Sasha, the talented surgeon who never acknowledged my presence, sat on the furnace on the right side of the vast room. Slowly I turned my head and saw that he had defeat written on his face as well. I looked at the remaining five patients.

"Who's next?" I thought, "Is there any purpose in going on?" Since yesterday, I had accompanied Natasha throughout her sepsis leg surgery ordeal: tried to keep her warm during the antiseptic cleaning while humming Billy Joel's "Lullaby," reassured her repeatedly that she will live, held her hand after her antiseptic bone leg wash until she fell asleep, asked the doctors to come over repeatedly because the 21-year-old syringe pump had stopped working and her blood loss from the site of the incision seemed too great, despite the blood transfusion.

I stood in the middle of the Unit, leaned against the bed and watched her mouth form the silent word in Russian, "Ho-lod-na." Cold.

Suddenly, Sasha got up and encouraged the closest patient to sit up so that he could inject heart activator fluids into his spinal cord. "Keep on going for the living patients," I thought.

Later I delivered her body to the morgue--partially out of my desire to see a Ukrainian morgue and also my sense of duty to stay with her until the end. However, after returning from that chilly, cement grey house, I remembered the comment my Ukrainian sister, Iryne, once made, "You are weird."

It was a generous statement, given that my activities in Kherson, challenged their Ukrainian motto, a relic from the Soviet era: "Those who take initiative are punished." Implicitly stated: Conform for an easier life. I understood the cultural perspective of Iryne's statement: Why would a vacationing American happily volunteer to do the hard tasks in our hospital. I returned, this time, to shadow the ICU director, Dr. Yuriy Antonovich, and his staff. They had delivered a speedy, but accurate surgery on my acute appendicitis two years ago when I was a Peace Corps Volunteer in Ukraine. As I recovered under their care, I saw that being a medical provider shared the basis of my fondness for my industrial and labor relations education: their family-like environment, their deep respect for the inherent worth of human lives, and their active involvement in solving multifaceted problems.

I hesitatingly went to work the day after Natasha's death. The vomiting grandmother, who I had gently encouraged in Russian, "excellent, and more, please," and whose body I nudged toward mine while holding the vomit tray to check for any abnormalities, smiled when I patted her bandaged incision site. I also went to the 5th floor to see Gelena, an Azerbaijan refugee who just gave birth. With each day, she was becoming stronger and more radiant. We agreed to take pictures of her baby at the Baby's Unit tomorrow. I cannot bring back life, but I still had my smile and my warm hand, and now, I was going to capture life for this young mother.

However, midway through my luncheon with the nurses, I went to the restroom and cried. It was not a long, loud cry, but a cry for everything--my lack of fluency in Russian and in medicine, my inability to answer Natasha's repeated calls to ease her pain, and her death. This was the irony of being a health provider--we defend the living, but at the same time, if we lose, there is no second chance: the person is dead.

Despite the harsh reality of this self-initiated internship, I voluntarily increased my hospital working hours, once even to a 12-hour shift. How can I ever forget the feeling of camaraderie as we lifted oxygen-masked patients onto their beds or watching doctors use their rest time to wash the intestines of bowel-obstructed patients. It was my quiet travels from the ICU to the surgery room and the recovery floor to see my patients which reminded me that it was this one-to-one togetherness with the critically ill and the staff--from the very start to the very end--that soothed my innate need for that most direct, intimate trust and bond.

Many images came to my mind that night: the spark in my recommenders' voices when they learned about my medical school pursuit, my patients' peaceful smiles when they held onto my hand--I cannot let these people down. I repeated my personal quote: perseverance requires the humility to accept the randomness in life, however unfair and unjust, but also knowing that in the absence of perseverance, there is simply no need to use the future tense.

While I cannot hum the "Lullaby" with ease again, I made a pact with death. When the time comes, I will humbly let my patient go. My urge to cry for those who passed away at the ICU will arise, but my tears will not form. However, before my patients dive into the last stage, sorry death, you will have to wait...for a very long time. I do not give up without a fight.

Today I arrived at the ICU and saw Sasha sitting by the desk as the rising sun marked the end of his night shift. With yesterday's sadness wiped away, I gave my I- refuse-to-lose smile, and said "Do-Brea- Yu-Tera." Good morning.

A subtle smile formed on his face, overshadowing those tired eyes.

Judy Wong received a MHS in Biochemistry and Molecular Biology from the Bloomberg School.

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