In the ER, we ask, Was he wearing a seatbelt
Partly for the note, but partly so we can remove ourselves
From exploded flesh, splintered bones,
Not sure if we can save that eye.
Something in us says, that will not be me;
I take precautions. We live on,
On the strength of the stories we tell ourselves.

But in the ICU, when one of our own has come in,
After a well-informed try at smothering the spark,
There is no separation.
We breathe for you
We mutter prayers for your renal function
We see you, and we see ourselves.

When a loving person starts the journey,
They hear, “Oh, you will make a great doctor, you are so caring.”
We think our compassion is an unstoppable force
Until it meets the truly immovable object.
And then, everything we do for our patients
Comes at a price that we pay
A drop of blood at a time.

It seems so small in the moment, another ten minutes,
Another call to a patient’s family.
But drops of water carve a canyon through bedrock
Tiny snowflakes gather where they fall,
and then comes the avalanche.

And for you, my sister, my brother,
I know: There was more and more
Piling on a psyche that had been ritually tortured
And then all other options
Went gray in the periphery, leaving only one.

What an irony, that if you had cared only
For money, prestige,
The conflict would never have happened.
They do not end up here,
The body fighting for the life
The mind can no longer cherish.

I wish I could have told you,
No, there is no way to win that game,
It is rigged! Stop trying!
Stop pouring yourself out
A small flask of pure water against a desert.

But I think we can find
A thread in the labyrinth.
And see, right here,
The wall that looks like stone
Is just an image, not real
If you say it is not.

I hope you make it
I hope you find a way to make your own peace
I hope the heroic you who made the bargain,
My youthful days traded for the art of healing,
Triumphs in the end.

Janet E. O’Brien is an internal medicine physician.