Code blue and contemplation

Fear, desperation, hope and ethics, the poetry is a glimpse into chaotic human drama, through the eyes of a doctor

In this journey, I’m not just an observer, I’m an active participant. My stories aren't clinical case studies detached from the soul, they are my soul's way of understanding the world, painted through the visceral medium of poetry.

With each poem, I delve into the diverse facets of emergency medicine, navigating the complex emotions, ethical challenges, and philosophical questions that define its terrain. This collection is more than just a series of poems to me. It’s a part of my quest to understand humanity, to feel deeply, and to connect with the essence of emergency care.

Through my words, I invite you to see the world through my eyes, to feel the pulse of life in the adrenaline rush of the Emergency Room (ER), and to join me in this deeply personal exploration. It's a call that goes beyond the surface, asking not just for reflection, but for a shared journey into empathy and action.

This is not just an invitation, it's a glimpse into the heart of what it means to heal and be healed. It challenges us, you and me, to look beyond the clinical and embrace the deeply humane side of healing.

***

In the dim light of dawn, I witness a child’s battle come to an end, not in victory, but in silence. For me, this is neither the first time nor will it be the last. The moment, captured in “C’est La Vie” below, is a stark reminder of the raw reality I daily face in emergency medicine. Through my words, my poem serves as a prelude, inviting us to confront life’s precariousness and the profound impact of loss on those who bear witness, be it family or healthcare providers in the ER.

C’est La Vie

Walked into the ER, dawn's light barely there,

A five-year-old boy, life hanging by a thread.

Fourth time they tried to bring him back since night,

Diphtheria's grip tight, a battle fought in vain.

 

8:05, silence fell, my shift just starting,

Life's fragility echoing off sterile walls.

"Wasted potential," a phrase that lingers,

His journey short, his words unspoken, a friend muses.

 

Stepped outside for air, the weight unbearable,

His family, a picture of despair, their world shattered.

Tears, maybe a brief solace in their overwhelming grief,

A stark reminder of the paths we all walk, alone yet together.

 

Years in the ER, you think you'd be prepared,

Yet, each loss, each farewell cuts deep, leaves a mark.

The lesson consummates in its simplicity: cherish those you love,

Hold them close, for in the end, that's all we truly have.

 

And so is life, a series of hellos and goodbyes,

A reminder of our vulnerabilities, of loves lost and found,

In the somber quiet, a call to embrace every moment,

For in its fleeting nature lies the essence of our being.

Through the above lines, I share the essence of emergency care — a realm where every minute may be a fight for life, and every decision a weight carried by those committed to saving others.

***

As the night unfolds, "Friday Night Shift" becomes a mirror to my own internal tempests, the ones I navigate as an emergency physician. This poem speaks to my soul, laying bare the turmoil and burnout that lurk beneath the surface, all set against the cacophony of my ER, made worse by a storm ravaging Karachi by night.

Friday Night Shift

Driving home, the echo of the ER's crazy Friday night rings loud.

Storm outside, a mirror to the tempest within—

Kids in need, no beds to send them to, parents in despair, the relentless dance of life and death.

"I think I'm done," says Inner Voice, "my clinical ER days might be numbered," the weight of it all a heavy shroud.

 

Then, a father by ER bed 2, his life entwined with his toddler's leukaemia battle,

Offers an unsolicited glimpse into my soul.

"You've changed," he declares, a keen observer from the shadows.

Ten months of unwitting observation, now he notes my faded zeal, my altered presence.

 

He mentions my weight loss, my unkempt hair—signs of a shift within.

"Where's the oomph?" He probes, missing the firm leader he once saw.

This man, a banker by trade, with a psychologist’s keen eye,

Shares his story, a year past, his kid’s diagnosis through Friday chaos, his own world upended.

 

His journey from denial to acceptance in that same ER, guided by blunt truth,

Reflects back on me. His concern, laden with genuine worry,

For he saw in me what I've yet to see.

A mirror held up, not in judgment, but in connection.

 

His words, more than a casual remark, a significant nudge,

A wake-up call amidst the frenzy, signalling a deeper sign.

The ER, a crucible of harsh lessons, yet also of profound human touch.

Tonight, it whispers of change, of rekindled purpose, of why we endure.

 

Carrying his observation, a beacon through my introspection,

A reminder of the storm we brave, of the sparks we kindle in its wrath.

"It's a sign," Inner Voice muses, clearer now in its contemplation.

A call not just to persevere, but to reimagine, rediscover, reinvent.

***

As the above drama played out, I found myself drawn into my own intimate reflections — a healthcare professional wrestling with the relentless demands of his calling. This poem mirrors my journey from the shadow of doubt to the light of rediscovery, serving as a testament to the resilience required to navigate existential trials in ERs. This isn't just another of my ER stories told in verse; it's a revelation of my own struggle, my own search for meaning amidst the chaos within and without.

***

Diving deeper into my own experiences, "Fragments of the Mind" becomes a journey through the layers of the human psyche that emergency settings so starkly expose. This poem turns into a personal dialogue, where I confront the vulnerabilities and strengths that mental health crises reveal. It's as if each verse speaks directly to me, reflecting the raw and unfiltered essence of what it means to stand on the front lines of ‘mind-brain’ fragility and resilience.

Fragments of the Mind

In the glaring light of the ER, as night unwinds its complex tales,

The unfiltered essence of the human psyche emerges, stark and unveiled.

A young girl stands in defiance, her battle not with the world but with her own shadows,

Choosing bleach over food, her silent rebellion echoes through the hollows.

 

A young man, his conviction in his own mythos, takes a leap, not from folly but belief,

Finds himself impaled, where reality and fantasy meet, a junction of grief.

His ordeal, more than an accident, a confrontation with his own mortality,

A harsh lesson in the limits of human frailty.

 

The scene shifts to a gurney, now a stage for unbridled mania to play,

A young soul strips himself naked, daring the world to see him fray.

His challenge, a raw display of vulnerability and defiance,

A poignant testament to the mind's unchecked alliance with chaos.

 

Amidst the turmoil, a pregnant woman's voice cuts through, a tempest of words,

Cursing in Urdu, invoking mothers and sisters, each utterance sharp as swords.

Her reality, fragmented by the use of street drugs, spirals into despair,

Revealing a lineage of care, distressingly laid bare.

 

These nights in the ER, where psyche's battles unfold,

Not just with medical interventions, but with stories untold.

Haldol and Ativan serve as temporary reprieves,

Yet, beneath the surface, a tapestry of human emotion weaves.

 

Thus, through each shift, lesson upon lesson we compile,

In the heart of the ER, humanity's trials.

Each encounter, a fragment of a larger story, a sign

We bear witness to the resilience of the spirit, divine.

***

In the above narratives, I witnessed shared psychological struggles of both patients and caregivers against unseen challenges transcending the ER's confines. This mutual journey illuminates our collective resilience against adversity, revealing a deep bond formed through trials encountered both within and beyond the hospital ER’s walls.

***

Expanding the vista, "Echoes Across Continents" bridges my individual experiences with the collective heartbeat of emergency medicine around the world. Encountering child abuse within the ER is a stark, global reality that I face regularly. When the story of an abused child in the ER resonates with my own experiences, the pain intensifies. To truly heal, we must move beyond mere words to tangible actions. Therefore, my poem reflects our shared mission and the universal challenges we face, reminding us that the quest to heal our children knows no borders nor time.

Echoes Across Continents

Fifteen years of split worlds, five Stateside, then ten where Indus unfurls.

In ERs, under different stars, I've borne witness to young lives,

A morning in turmoil, a boy of ten, his innocence questioned,

Brought under harsh lights, a story of rape, starkly laid bare.

It's not the first tale of darkness I've heard,

Nor, I fear, the last, each narrative a heavy burden.

 

In these corridors, both near and far, a similar pain resonates,

Children entangled in distress beyond their understanding.

Their eyes, wide, hold untold stories,

Reflecting my own history, my own choices taken from me.

 

The cook's shadow looms large over my silent years,

A trust broken; a secret kept through unshed tears.

At ten, I, too, was lost, with no words to say,

What happened in the dark, in the light of day?

 

Now, as a kids’ ER doctor, I stand in this breach,

Across continents, it's their trust I seek to reach.

From USA's advanced halls to Pakistan's resilient walls,

I carry their stories, a weight we all bear.

 

This isn't just about draining wounds or setting bones right,

It's about hearing their silence, fighting their fight.

Fifteen years in, and the journey feels new,

Each child's gaze, a reminder of the work left to do.

 

The ER shouldn't be where these stories unfold,

No child should through these doors, their nightmares told.

Yet, here we are, in spaces filled with fluorescent light,

Holding their hands, ready to fight their fight.

 

In this role, I've found a voice, perhaps,

To speak for those whose pain is masked.

Across continents, under different skies,

We're united in this mission, until no child's voice dies.

***

Beyond the Break

In the still moments between alarms,

where urgency and hope find their fragile balance,

we confront the quiet aftermath, the echoes of sudden stillness.

Bodies recount tales of sudden stops,

each injury a narrative of life interrupted, managed in the ER's glare.

 

Within these walls, questions hang heavy in the air,

how to knit together lives unravelled by trauma,

in environments where comprehensive care barely glimmers?

 

Our hands, marked by fatigue, craft resilience stitch by stitch,

each effort a stand against despair,

a pledge to those swept up in unforeseen calamities.

Yet, in the grip of grave injuries and survival's faint whisper,

we face decisions shrouded in the gravity of *DNR [do not resuscitate],

a sobering choice in lands without the safety net of comprehensive healthcare,

where the burden of rehabilitation's cost casts a long shadow.

 

Here, amid daunting odds, our roles expand,

embracing the solemnity of guiding dignified choices,

in the absence of a path paved by systemic support.

 

Beyond the frontline of trauma care, a call echoes deeper,

urging not just healing, but a bold reimagining,

a reconstruction of not only shattered forms but the core of our caregiving ethos.

In our pursuit to ease the sting of injury,

we unearth our broader mission—

not only as restorers of the broken but as architects of a new dawn

where every action, every policy decision illuminates the value of life,

resonating in the resolve of those committed to change.

 

Our journey takes us beyond the immediate, advocating for systemic transformations,

like rethinking traffic systems to prevent the traumas we so often see,

pushing for health policy reforms that prioritise prevention, care, and compassion.

In this commitment, our deeds weave a narrative of hope,

envisioning a path where healing is not just a personal journey but a societal stride,

a collective movement towards a future where care is universal,

and the roads we travel are safer for all.

***

Concluding our voyage — "Beyond the Break" is a plea for systemic transformation; a call to action that reverberates beyond the immediate confines of emergency care. This poem envisages a future where prevention, comprehensive care, and policy reform are seamlessly integrated into the healthcare fabric.

There is hope.

 

Asad Mian MD, PhD is an ER physician-researcher-innovator at the Aga Khan University and a freelance writer. He writes on topics ranging from healthcare and education to humor and popular culture. He authored 'An Itinerant Observer' (2014) and ‘MEDJACK: the extraordinary journey of an ordinary hack’ (2021)

All information and facts provided are the sole responsibility of the writer