Cri de Coeur
Naderge Pierre ~
As a surgical resident nearing my final year of training, I loved to operate. Whenever I was on call in the trauma unit at our large urban teaching hospital in Washington, DC, I'd yearn for my pager to go off.
I was always tired, too--but for a surgical resident, fatigue is a given. Sleep and eat when you can, get your work done and operate like a madwoman: That was my life. It felt like a high-adrenaline thrill ride, and I was enjoying every swoop and turn.
I never expected that, while racing towards the final exhilarating peak of my training, I would become a patient myself.
Ironically, it happened right after the most memorable surgery of my trauma rotation.
The patient, a man my age, had suffered multiple gunshot wounds to the chest and abdomen. Donning my surgical gown, gloves and mask, I felt my heart and adrenaline revving up in anticipation.
The man's heart stopped beating as he rolled through the emergency-room doors, but I cut into his chest, spread his ribs, moved his lung out the way, clamped his aorta and put my palms over his heart, squeezing it rhythmically. At first it refused to revive, but my team and I refused to give up. Finally, the man's heart jumped--and so did mine, as if in sympathy.
Working on the man under the glaring operating-room lights, I sent up a silent prayer: Lord, please guide our hands.
Over the next hour, my team and I threw every ounce of our skill into trying to save him--removing damaged organs, suturing and stapling holes, fixing bleeding vessels--while his heart taunted us with faint, erratic rhythms. My own heart pounded as if it might rip through my chest, but I ignored its throbbing and the occasional jab of pain.
Finally the man's heart gave up, and he slipped away. Even amid the tragedy of his death and the loss to his loved ones, I felt elated at the immense expertise and dedication my teammates and I had devoted to him. It felt like the crowning moment of my training.
Two days later, that night ran through my mind as I sat in the emergency room. After the surgery, my heart had continued to race, my chest pain had intensified, and I'd become breathless. Now I was a patient myself.
I never get sick: That had always been my silent mantra. But, like my patient, that mantra had been mercilessly shot down.
As it turned out, my heart had been trying to get my attention. Now I was finally forced to listen.
"Your heart is enlarged," the ER doctor said, "and your cardiac enzymes are elevated." My chest CT scan was abnormal. No diagnosis was in sight, but a multitude of possibilities raced through my head: heart attack, heart failure, pulmonary embolism....
My father (a farm-labor contractor), my homemaker mother and my four siblings were back home in Miami, hundreds of miles away. Feeling utterly alone, I shed a few tears in my room.
The next morning my heart's inadequacies were ruthlessly exposed. Scanning the echocardiogram screen, I saw how weakly she was pumping--less than half the normal capacity. I feared that she might stop at any instant, but--perhaps out of spite at my obliviousness--she beat on in a mad fury.
I felt defeated. I wished that I could plunge my hands into my own chest and give my heart the extra boost she needed.
Being a patient in my own hospital felt like a surreal, out-of-body experience. As the medical residents examined me that first day, I saw myself morph in their eyes from being a fellow resident to being a "good case." They surrounded my bed, staring down at me, furiously scribbling notes and speculating on my diagnosis as my own mind also raced through the possibilities.
"I think you have sarcoidosis," one declared presumptively, as I stared sullenly back at him.
I'm going to need a left-ventricular assist device and a new heart, I thought miserably. Another surgeon is going to put scalpel to my chest and put her hand on my heart to support it--or replace it.
That was the best-case scenario. The worst case...I have seen a patient die while waiting for that saving organ. Now it was my turn to wonder, Where am I going to get a new heart?
Seething over this unexpected road bump, so close to the end of my training, I also wrestled with nagging fears: Will I be able to be a surgeon? Will I be able to have children?
As I repeated my story to the residents and attendings, I put on a brave front and a big smile--but inside, I felt blinding rage, despair and sadness. At day's end, I could no longer keep my emotions at bay: Sitting in my hospital bed, feeling utterly alone, I broke down and sobbed.
But I soon discovered that I was not alone. We all joke about our "work families"; my fellow residents, attendings, social workers and nurses truly were my family. They made the needed phone calls to the head cardiologist and checked on me often to ensure my comfort. After my cardiac catheterization, one resident brightened my day by volunteering to "hold pressure" on my femoral artery so that I wouldn't get a bruise. And when my coworkers learned that my family couldn't afford to visit me, they started a crowdfunding platform to pay for the trip--and for my rising healthcare costs.
After seven days and multiple diagnostic tests, I was finally diagnosed: It was lupus, an autoimmune disorder. Disguised as a resident's normal fatigue, it had been ravaging my heart, lungs and mind.
Lupus isn't curable, but its symptoms can be controlled with medications and other therapies. Knowing this, I felt relieved that I could manage the illness, and hopeful that my heart could recover without any lasting damage. I felt supported, too, by the assurances of my doctors, family and friends, and most of all by my faith in God.
I diligently followed my doctors' recommendations, including having a defibrillator implanted to prevent a deadly arrhythmia. My heart function significantly improved: It turned out that I don't need a left-ventricular assist device--or a new heart. Although my heart hasn't yet recovered fully, and I sometimes get very tired, I feel well overall.
Despite my illness, I pushed ahead with my career goals. After a two-month break, I returned to training and completed my general-surgery residency, and the following year I finished a colon-and-rectal surgery fellowship. I'm becoming the surgeon I aspired to be.
It's no coincidence, I believe, that my mother named me Naderge, which means "hope" in Haitian Creole. And years ago, I got a tattoo of an Adinkra symbol, Biribi Wo Soro, which means "God is in the heavens." It's a saying whose hope and faith I feel express my spirit. I am a survivor; I look forward to being a practicing surgeon and a wife and mother, and I'm confident that hope and faith will continue to guide my existence.
I can feel her, my heart, beating graciously--and I find myself full of hope that she will one day regain her full power.
About the author:
Naderge Pierre is a Haitian-American from Miami. After completing medical school at Florida State University College of Medicine, she did her surgical residency in Washington, DC, and recently finished a surgical fellowship at Northside Hospital in Atlanta. She will soon be practicing in Frederick, MD. This is her first published piece. "I'm not a writer; but my trauma attending physician encouraged me to write about my experience as a patient. She also played an important role in saving my life: She forced me to visit the emergency department on that fateful day. Writing this piece allowed me to verbalize my fears and embrace who I was becoming."