The Bridge to Nowhere

I was the only physician on duty when the bus crash happened. It was 2:14 AM on a Saturday, and I had already been working for eleven hours. The hospital was a twenty-five-bed critical access facility in rural Nebraska, seventy miles from the nearest Level 1 trauma center. I had two nurses, a lab tech who doubled as a phlebotomist, and a part-time radiology tech who lived fifteen minutes away and had to be called in from home for anything more complicated than a chest X-ray.

The bus had been carrying a church group home from a retreat in Colorado. It hit a patch of black ice on I-80 and rolled into the median. There were twenty-seven patients — broken bones, internal injuries, head trauma, lacerations. The triage was brutal. I had to make decisions in seconds that would affect people for the rest of their lives. Who gets the CT scanner first. Who gets the blood products. Who gets medevaced to the trauma center. Who waits. Who might die waiting.

I made those decisions. I made them alone. And for the first eleven hours of the response — as the medevac helicopters came and went, as the surgeons in Omaha worked on the patients I had stabilized and packaged, as the families arrived at the hospital looking for their loved ones — I functioned. I didn't eat. I didn't sit down. I didn't cry. I was the doctor, and doctors don't fall apart during a mass casualty.

It was 1:15 PM, sixteen hours into my shift and eleven hours after the bus crash, when the last patient had been transferred out and the emergency department was finally quiet. I walked into the staff bathroom, locked the door, and collapsed. Not fainted — collapsed, physically and emotionally, onto the cold tile floor. I sat there, back against the wall, and wept. I wept for the patient I couldn't save — a woman in her sixties who had coded in the CT scanner and never came back. I wept for the families I had given bad news to, the phone calls I had made, the decisions I had second-guessed and would continue to second-guess for years. I wept because I was exhausted beyond any exhaustion I had ever experienced, and because I didn't know how I was going to come back to work the next day and do it all again.

The myth of the invincible physician is one of the most destructive stories in medicine. We are taught, from the first day of medical school, that we can handle anything. That we don't need sleep, don't need food, don't need help. That showing emotion is weakness. That asking for support is failure. This myth kills physicians. It contributes to the 300-400 physician suicides every year. It contributes to the burnout that drives talented doctors out of medicine. And it is a lie.

I sought help after that shift. I started seeing a therapist. I joined a peer support group. I learned to say "I'm not okay" and mean it, and to accept help when it was offered. I am still an ER doctor. I still work in a rural hospital. But I am no longer the doctor who locked herself in a bathroom and cried alone. I am the doctor who knows that the bravest thing you can do in medicine is admit you need help — and then ask for it.