“How's Work?”

[Ann Emerg Med. 2009;53:157.]

“How's work?” my roommate asked me as he does every night.

Seems like such a banal question. It's easy to ask, and rolls off the tongue well. For some people it comes out as part of a standard greeting. “Hi, how are things? How is work?”

People ask it all the time. Do you really want that question answered? To be honest, I don't think you do. Ok, maybe some people really have a genuine interest in knowing how my work is going. Most people, it seems, just want to hear a 1- or 2-word response. They aren't really looking for an answer, just an acknowledgment of the fact that they expressed an interest in your life and wouldn't you kindly do the same.

Regardless of who is asking, though, I can't help but think of the real answer to that question.

How is work?

I am a second year emergency medicine resident on the trauma service. It was a night no different from all the others. I worked 11 stabbings in 6 hours and 8 gunshot wounds in 5 days. A man high on angel dust ripped the front off his own trachea, and a drunk drove his car over a grandmother and her grandson. Four people were assaulted by members of their own family.

Five days ago, I told a family that because of the extent of his head trauma, their 19-year-old son will never wake up or speak to them again…if he lives. They cried. But then I told a husband that his wife just regained feeling in her legs after shattering her spine last week. He cried also.

I saw a brittle, demented old lady with so many problems that almost every service in the hospital saw her for one reason or another. She was always in pain and cried continuously. She died and I was thankful.

An old man with a wasted wine flask for a liver died in the ICU. I spent 4 hours trying to track down the next of kin. I couldn't find one, and for once, nobody cried.

Early in the week, our biopsy revealed a malignant tumor in a 9-year-old. Generous estimates give her 2 years to live. That afternoon, I went to check on my 5-year-old with appendicitis. Before surgery, he couldn't move from the pain. That day he ran to me in the hallway and hung on to my leg for the rest of the trip to his room, giggling the whole time.

I drove home recently with blood on my shoes, vomit on my scrubs, and a little sticker on my lab coat that said “Smile.”

I work for people with big brains and monster egos. My chief made a point of calling me unreliable in public and I felt the same as when I got the crap beaten out of me in elementary school with the whole sixth grade watching. My attending later told me I was doing a good job and to keep up the good work and I felt like a schoolboy who just got a big smile from the cute girl.

How is work?

Work sucks the big one. Work is fantastic. Work is the most miserable experience of my life and the greatest thing I have ever done. Some days I hate to get up in the morning and some days I don't want to go home. I wish I never went to medical school and then I remember why I went to medical school. I hate it. I love it. I deserve a better salary, and I would do this free. I'm poor as hell and a hundred people I know are jealous of my career. I want to quit and I would never forgive myself if I did.

So, I'm home for the weekend to see my parents. The whole family is there. I step in the house and tense up because I know it's coming. I can almost smell that question hanging in the air, waiting for someone to grab it and throw it at me. Hugs, kisses, nice to see you. I take off my coat and scan the room for the culprit. I know it's coming, and I can't get away.

Ah, there it is. “So, how is work?”

A blistering tirade of responses flips through my head. They are all there, screaming to be heard. I push them all down and, like a switch, a casual shrug serves to turn that part of me off.

“The same. How are you?”