For this trauma surgeon, a day’s work is always about life and death

James Street reflects on the emotions that come with the job — and the power of just talking.

James Street, 48, is a trauma surgeon at Medstar Washington Hospital Center, where he has worked for 16 years. A father of four, he lives with his wife in Maryland.

The very nature of your job is life and death.

That’s right. But in those moments I don’t really see it that way. Those thoughts don’t really enter my head. It’s just go time. What I see is a human being in dire straits, and what can I do to assist that person?

When I go home after work, I can tell my kids I wrote a story. You can tell your kids you saved somebody’s life.

Yeah. Essentially. And my daughter loves it. She went through my phone and saw some pictures of surgeries, and I thought she would be horrified. But at least once a week she wants to see pictures. I have some suturing stuff at home, and she’s always practicing. She says she wants to do that when she grows up.

What’s the most disappointing experience you’ve had as a trauma surgeon?

Losing a patient that I feel I should have been able to save. When somebody comes in alive, I always feel like they should make it. So the hard part is, say they come in talking and I get them to the operating room, see that their injury is probably not survivable, and my heart just sinks. You go all out trying to do what you can do, and you look at the monitor and see the blood pressure falling and you know, Ahh, there’s nothing I can do here. Those really hurt.

And when that happens and you’re driving home that night from work, are you still thinking about it?

Honestly, I probably don’t deal with that very well. That drive home I’m a thousand times going back over everything. When they hit the door, could I have been faster ordering blood? Should my surgical approach have been different? I replay those things. And my wife knows. She can tell by the look on my face when I get home what type of day it was.

For most people a bad day at work doesn’t involve someone dying.

Right. I’ve learned how to keep it separate. That’s the only way I could stay sane. Because I can pronounce somebody in the operating room, and it’s really sad. And I feel those emotions. But four or five minutes later when the family comes and I have to sit and talk to them, and two or three of them are on the floor crying, it just breaks your heart.

Do you hear back often from people whose lives you’ve saved?

Yes. I make a point to build relationships with patients. I get cards at least every other week. I’m their doctor first and foremost, but it’s important for me to become just Jimmy. To just talk with them.

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