Compassion Training

You would think I would have written about you earlier. I am sorry. Someone has failed you, little toes. Little fingers.

I watched myself open the car door after it was done, and I know I cried there. I know I drove around Denver and lost an hour. I don’t remember really. The nurse waved at me, and it was raining. Cold rain. I didn’t wear my coat inside that night. It was warm going inside and cold when I left.

You should practice self-care. You need to call someone. Your mother. Your girlfriend. A therapist.

I still have Medicaid. I scrolled through a list of therapists. I don’t trust the one at my school, because I don’t trust my school. No one is available. I have felt this way before.

Just a month earlier, I was in a small town during the Pulse shooting. No one called. No one from my family called. They moved to my state, but I was alone in the middle-of-nowhere Colorado with the weight of what this was, what it meant, knowing what we were losing as a country. What we kept losing as people. Knowing what I had lost as me.

I came home after being away on clinical rotation during the Pulse shooting, and I couldn’t sleep for five days. I woke up at four in the morning, cleaned and organized. On day five, my girlfriend sat on my couch, concerned. Watching as I disrupted my entire house, opening the drawers. Taking everything out. Throwing away bags and bags of things. “Decluttering.” “Purging.” I surrounded myself with pieces of paper organized by titles. “Things I want.” “Things I need.” “Things to buy.” “Things to throw away.” “Things to do.”

“Things to fix.”

The first thing on that list was “Me” and the second thing was “The United States of America.”

“Why are you doing this?” My girlfriend asked, confusion in her voice, eyeing the contents of my fridge and my closet and my drawers spread out in piles in my studio apartment. She sat so calmly. Moving her hands through her brown hair, watching me frantically writing and dumping out drawers.

“I just want to organize. To make my place clean. I want people to feel welcome.”

I want people to feel safe.

I went to my doctor after a week of not sleeping after the Pulse shooting. “I am concerned I may be manic.” She wasn’t sure. She threw out the names of heavy-sounding medications. I knew enough to know I wasn’t willing to be diagnosed based on one event. I knew the side-effects. The blunting. My insurance wouldn’t let me access behavioral health, even if I paid for it. I needed help, but I did not need to be in an emergency room.

I had already been told studying medicine would steal my creativity. Would I let chemicals? I knew and know better. I have studied psychology. I study medicine. I study people. I know those chemicals save lives sometimes.

I went to my mother. “I am concerned I may be bipolar.” “I know you,” she said. “You are not bipolar.”

I waited, and it went away. There was the nagging flash of memory — just two months prior, I had held too many pills in my hand for just a little too long before packing a bag and spending the next four days at friends’ houses so I wouldn’t be alone. I can’t access that person now. I couldn’t access that person then, when I had the energy and the racing and the need to fix as much as I could get my hands on to fix.

I am aware of what to do and not do. What to feel and not feel. The bargains I make with myself. I know not to listen to sad music. I know not to watch sad movies. I am my own gatekeeper for feelings because I know what letting myself feel too much can do to me. I know I feel later.

So I knew now, preemptively, that I would need help. “I am available on weekends and nights,” I said in messages. To therapists. “I know I am okay now, but I know I might not be,” I whispered to my girlfriend, arms around her in the dark, wondering where my feelings were and how watching myself not feel could be so painful.

Little fingers. Little toes.

During my shift in the Emergency Room tonight, a baby had a tiny hair wrapped around his toes. His little toes were turning pink and blue and purple, and we inserted a needle between his toes to block the pain before we cut through his toe. And he screamed, and his face scrunched up in pain. My heart squeezed and flip-flopped and a course of pain went through my chest and bubbled up from my chest into my throat. I’m sorry, little one. He went home.

Three hours later, I watched myself using three of my fingers to pump the blood for a baby who had been shaken, or hit on the head. “One, two. One, two.” Proper technique is two fingers.

He had been fine for several hours. It was a rough intubation, but his oxygen was good. He started to wake up, and flight for life was finally there to take him away.

“Things to fix.”

I should work out. I should be stronger so I can do this longer.

I should paint again. I need to paint.

“One. Two. One. Two.”

This is why we are doing this. So his blood can go throughout his body. This is why even though you can feel ribs cracking, we are doing this.

Little fingers.

It’s like the finger. We took the finger off so that it would not die and become infected, so the infection didn’t spread to his body. It is just like the finger.

“One. Two. One. Two.”

His heart rate dropped lower, and lower, and lower.

“One. Two. One. Two.”

I watched myself, doing compressions on this little bit. Mom was begging us not to stop. Doctor said to stop, and you were the last one doing compressions, but he was already gone and

The ultrasound said he was gone

And you stopping doesn’t make him more gone than he was before.

Baby had tubes, and the flurry stopped. The doctor braced himself against the counter, breathing for a second.

I’m thirsty. If I’m thirsty, he is thirsty, and he is sad.

I watched myself walk to get a Styrofoam cup, and I stole a Sierra Mist from the fridge. I filled it only a third of the way through with ice half is too full and before that it was too empty. Too much ice. Too little ice.

Things To Buy: My brother graduated and my mom has a birthday. I should spend time and money with them, you never know. We will go to brunch and comedy and horseback riding. You never know, be intentional.

Things I Want: New shoes so I can look pretty in my dress.

You shouldn’t compare sadnesses. I paid $60,000 to learn that. There’s famine in places like Africa. Three-month-olds come in alive and then they die and there is no music accompanying it, and I have to come back tomorrow and so does that doctor, and we have to be there to get stones out of noses, and make feverish five-year-olds laugh with us and trust us, and make them feel better.

My best friend moved to Australia. Her car was stolen, she said.

“How are you?” She asks.

Your car got stolen. You will get the insurance money. You are fine.

This isn’t your tragedy. I insist to myself. Don’t be selfish. This isn’t your tragedy, don’t own it like it’s yours.

I know my feelings are not convenient. The next day I had to go to compassion training. My feelings never come at appropriate times. In a room full of strangers, I see myself 10 years ago in the story of how a five-year-old was dead on arrival in Kenya, and the young white medical student tried CPR again even though CPR had been completed unsuccessfully. “And then they wrapped him in a blanket.”

White with faded blue stripes. Yellow ducklings. My eyes burned and I wanted to scream it out loud, that this thing had happened, and I might have feelings and I might not.

“You didn’t say a word,” my friend Jess said. “At the compassion training. You didn’t talk the whole time.”

It was an hour. Coping mechanisms: glass of wine, (but not too much, they said), and drawing (I should paint again), talking it out.

“Yeah.” I said.

That nurse, who waved at me, as I left the hospital, still won’t stop talking about it.

“Was that your first code?” She asked. “I bawled for days after mine.”

“I have never seen anyone die before.” I paused, knowing I was going to give something away about myself that I was not sure I wanted to. “I had more feelings about the digital block.”

Things To Do:

I have been cleaning again. My ER rotation is over, and it has been a month since you died. My desk is the junk drawer of my life. All the notes, all the things I learned studying medicine. Big trash-bags full of notes, stuffed to the brim with binders and illustrations, the chaotic handwriting of a stressed-out student. One pile for loans I have paid off. One pile for my house. One pile of letters loved ones have sent me. One pile for things to complete. Neatly stacked chaotically (but I understand where).

Laundry. All of it.

Cleaning my car. My bathroom. My dog. My body.

“Babe? What’s the occasion? Why did you buy white roses?”

Yellow ducklings.

“I buy flowers for myself sometimes. No one else does.” Picking fights.

White with faded blue stripes.

“It’s just kind of weird. People don’t usually just have white roses in their house for no reason.”

Little fingers, little toes.

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Katie is a medical professional living in Colorado. Katie loves to write, travel, take photos of lovely things, cook, hang out with her girlfriend, family, and small puppy. She is adventurous in the kitchen, and can be found adding potato chips to Bison burgers, scheming about ways to be the kind of person who owns a porch swing, and planning her next adventure. She has many opinions, and likes too much cream in her coffee.

Katie has written 1 article for us.


  1. I never expected to start the day crying into my coffee, but here I am. This is beautiful and heartbreaking. I relate so much to the list-making and purging when everything around me feels out of control. Thank you so much for sharing this.

  2. Holy shit. Just… holy shit. I felt this really hard.

    I used to work at a place for adults with developmental disabilities, and there was a lot of physical care and responsibility to keep fragile older people safe and unharmed. Two people I cared about very deeply died while I worked there, and it fucked me up real bad. Also got hurt there while taking care of people myself more than once.

    Not the same thing as working in an ER, of course, but I relate so much to the feeling of your job causing mental trauma and weird bottled / exploding emotions,

    • Oops, hit submit too soon. Anyway, just wanted to say that this was beautifully written and arresting. Thank you for sharing it.

  3. Ooof, honey.

    Compassion is hard and compassion fatigue is hard and All the Things are hard. I hope you get what you need.

  4. Wow Katie. I so hear you, I get you, you are loved.

    I remember my first code, my first trauma. Training makes us numb so we can function logically outside of our emotions. To keep them well hidden behind walls so we can remain level headed in the face of the unspeakable. So much so that I have trouble expressing my emotions, sharing them. I’ll cry at a stupid commercial and yet I stumble over and through my own emotions just to box them back up and repress them again. I get it.

    Be kind to your self. Thank you for writing this and sharing.

  5. My heart is in my throat. My face is a windowpane keeping the tears out of the physical world. I wonder if people can see them running down the inside of my face.

    Thank you for being a healer. Please take strength from knowing you are not alone.

  6. Ooof, this was beautifully written. I felt this deeply as someone in a caring profession (mental health) but mainly as a partner of an ortho surgery resident.

    Does anyone know of any resources/support groups for LGBT+ partners of doctors/residents? I have done some googling and am appalled at how heteronormative and vomit inducing the “MedWives” movement is.

    Or we can start one? anyone else with me?!

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