I focus my attention on the cheap, off-white 2x4 foot drop ceiling tiles to distract myself from the sharp pain of the needle digging into my arm. My brain is perseverating on the emergency department. I feel as if I never leave the hospital. Even during brief, blissful periods at home, I often dream of being confined in the blue-grey walls of the ED. My goals are to recover from events I’ve endured, horrors I’ve seen, and mistakes that might have been made along the way.

Being a patient strips people of their autonomy, their agency. Always overcrowded, with patients shoved into every corner, squeezed into every available crevice, docs and nurses must spend more time behind their computers than talking. Now that I’m here, I only add to the problem. There’s always more to say, but I know that no one has time to converse. No one has the time to hear what I’m really going through.

The piercing pain spreads along my forearm then dulls into a mild, constant burning sensation. It’s a feeling I’m never quite used to, but I can now anticipate that transition. Trying to relax, I take deep breaths. To distract myself, I envision the myriad faces and patients I’ve seen at the hospital. But my empathy envelops their pain, too. Even when I don’t want to, I carry other people’s struggles with me.

The pain transitions to adrenaline. My heart rate rises, my vision zeroing in on gloved, accomplished hands working smoothly at my side. My fingers twitch a bit as the nerve is stimulated. I think back to my hand balling into a fist, imagining that one day I wanted to strike a physician with whom I fought. But there’s no need to fight each other. It’s just the stress, the pressure-cooker of the ED, the suffering, the sleep deprivation – it gets to all of us, eventually.

There’s no rest in a hospital, no reprieve from the onslaught of human suffering. We’re overwhelmed. Exhausted. Stretched. A few drops of blood are wiped away. My arm is numb. We’re almost finished. Some pain and scars run deep, but instead of hiding them, I proudly wear mine on my sleeve. I fantasize of a future where I can regularly spend time at home, with my family, and not in the sterile confines of a hospital room. The gloved hand reaches for a bandage as I steel myself for what comes next.

When he’s done, it’s back to the hospital I go. For another shift, another day of being an ED resident, another day of wondering whether my actions resulted in the death of another human being. One with whom I’ll never have enough time to connect, never really know, but either way be tasked with telling the love of their life that they died. The vision I held, of connecting and helping and healing, is all but faded. Modern medicine is a dull slog, with more red tape than treatment, more charting than patient care. I chose this, I know I did, but I didn’t know, didn’t really know, what I was getting into. Which is why today, before my shift, I went to my favorite artist and added new ink to my arm. This tattoo is for my patients.