Life, Death, Madness


Confronting the raw reality of the emergency department

July/August 2008


My pager is a tiny sound-knife, slicing into my sleep. I sit upright, disoriented. What? What! It's Sunday, 2:30 a.m., and I'm the clinical social worker on call for our upstate New York public hospital. "They need you," says Liz, the overnight Emergency Department clerk. "There's a trauma and a lot of family. They need social work."

I dress in the dark and jump into my car. The streets are empty, abandoned by a sleeping world. Traffic lights blaze for no one; the street lamps are strung like jewels. As I pull into the ED parking lot, I see a mass of police cars, Emergency Medical Transport vans, and flashing lights. An African American family mills around the entrance, while perhaps a dozen others—friends, other relatives—pace frantically nearby. I'm waved through the door by security and walk quickly to the trauma room, where I see 20-some medical staff intently pumping, infusing, and cutting. Bloodied clothes and sneakers litter the floor.

As I step back out, the charge nurse, Bette, greets me. "What do we have?" I ask.

"We need you with the people out front," says Bette. "No one's been able to talk with family yet. We need the patient's parents, a wife, or a significant other inside. Nobody else—no young children, no friends. Can you sort that out and accompany them in?"

There'd been a picnic. A hot summer day and a neighborhood dispute had turned to shooting. A young man named Cyrus Johnson had been shot point-blank in the chest. Now…

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