Twenty five years ago today the space shuttle Challenger exploded after lift-off. Where were you that day? Do you remember?
I was 31, a young physician assigned to the hospital wards, responsible for teaching medical students, interns, and residents for the month of January 1986. In my eighth month of pregnancy, I was looking forward to the birth of our first child in February and the exciting opportunity to put medicine aside for awhile and open the door to motherhood. Chris was due in mid February and from a physical standpoint, I wasn't exactly waddling but I felt full, my back hurt, and I remember saying to anyone who would listen that the last 6 weeks of pregnancy were not physiologic as much as they were pathologic.
The days on duty were crazy busy. An older, terminally ill man was transferred to our service from M.D. Anderson Hospital, desperately ill with cancer, sepsis, liver and renal failure requiring dialysis. His family was the biggest problem; they were all of the mindset that everything and all needed to be done to save his life and nothing less than success was acceptable. There was no sense of reality, they were needy, almost hysterical, unwilling to accept that their loved one would inevitably succumb and that no amount of intervention would save him. Every morning, one or more members of this family would approach me the moment I stepped off the elevator, wanting an update and my daily plan of action before I had an opportunity to see him. In their minds, he was my only patient and despite the assistance of my team, I became the source for any and all information. Updates were expected multiple times a day. Their questions and needs were endless. Their grief and anguish were palpable. This went on for days and as he became sicker, the tension escalated. I grew weary of their unrealistic expectations. They likely grew dissatisfied and frustrated with me, sensing my distance and maybe my honest feelings filtered through my calm, cool, and collected facade (I was much better with this early on in my career). Tough situation. In retrospect, in all my years I don't recall a family as intensely invested in saving a loved one despite the futility. I was young, desirous of pleasing, comforting, and probably promising things I could never deliver. Meanwhile, he got sicker and sicker.
The morning the Challenger blew up high above the ocean off the Florida coast, I watched the unfolding and recounting of the tragedy over and over on the television on the hospital ward. We stood in groups, shocked, disbelieving, watching and feeling the sorrow spread like an eerie anguish. I still can't bear to watch a film clip of the explosion, especially the view of spectators, including Christa McAuliffe's father watching the sky in confusion; he must have wondered if all that smoke was "normal" while knowing deep inside that something was terribly wrong. Awful.
Within the hour, the wife of my sickest patient pulled me aside and literally chewed me out, criticizing my decision making, the overall care of her husband, and proceeded to pin his deteriorating status and imminent death on me. I held my cool. Professional. Listen more, speak less; everything we're trained to do but which took every ounce of my strength to quell the impulse to lash out, curse and scream in my defense.
After the tongue lashing, I took a time-out and retreated to my office but was barely thirty feet removed from the scene when the tears started welling up, uncontrollably. I felt scoured, humiliated, rubbed to raw with no (professional) way to respond other than to "take it". Lo and behold, I had my weekly checkup with my OB doc that same morning. As I blotted my puffy face with tissues and pulled myself together for the appointment, she was perceptive enough to ask, "What's wrong? Have you been crying?". That's when flood gates opened all over again and I spilled it all out; the stress of the hospital wards and this patient's wife jumping all over me. She was appalled, picked up the phone, called my boss and said, "Kate has to go home. Right now. She needs a break. She needs to rest."
And so, I did. For two days I lay in bed and watched TV, re-witnessing the explosion of the Challenger over and over and over again.
Then I went back to work but by that time there was only one more day, January 31st, and my ward duty was over. When I returned, my very ill patient had died and his wife/family were no longer around.