Editorial, Personal

Can You Find the Heartbeat of a City in the ED?

Dear Dad,

 I'm moving to Detroit.


Your only daughter

I'll never forget telling my family that I was moving to Detroit. My incredibly sweet, quintessentially Southern grandmother looked me straight in the eye with a tilt of her head, one hand flying instinctively to her chest, and said, “Bless your heart.” I can only imagine the thoughts that were racing through her mind at that moment. Everything she knows about Detroit is based on the few news stories that make the national headlines. As you can probably imagine, those are not the stories about the endearing families surviving here, or the incredible culture, or the culinary gems. These aren't the stories about a community banding together. No, the headlines flashing across Mrs. Kitty's mind are “10 Found Dead in Abandoned Home, Suspect Drug Connection,” “Financial Situation in Detroit More Bleak Than Ever,” “Detroit Police Funding Cut, Crime Out of Control.”

I remember countless conversations over the following weeks, trying to set my family's minds at ease. It was an impossible task in the face of those headlines. But in the end, my family trusted me and had faith in my strength and courage to rise to this new challenge. And here I am 2 years later, on a flight to Dallas to visit my family, wearing a shirt emblazoned with “Detroit Spirit,” not sure which “D” I truly call home anymore. Detroit has become a part of me. I speak fondly of Eastern Market, Metro Park, Slows Barbeque (although I'd deny it to any of my Texas friends), and Comerica Park like they were places I grew up visiting. And what's more, I will fiercely defend Detroit to anyone who dares look down on us. Yes, I said “us.”

All of this is in the face of the terrible things I witness daily in my job. What brought me to Detroit was an amazing work opportunity. But what keeps me in Detroit is a much longer story. I am in my final year of emergency medicine residency in the great city of Detroit. A shift does not pass without taking care of a patient who has been a victim of a violent crime. And these are the stories we hear about. But in between this constant reminder of the violence and sickness present in our city, are the stories I remember. There was a 67-year-old gentleman who presented after falling at home. He was a recently laid off Ford employee. He had lost his insurance and had been putting off seeing a doctor. He is a diabetic and didn't take very good care of himself. He had fallen because he had debilitating peripheral neuropathy that kept him in constant pain. Our encounter in the emergency department was going to be his only interaction with a physician for the next 3 months, although I didn't know that at the time. There was no indication for admission, so I had to send this gentleman on his way. My next patient was a 27-year-old single mother of 2, who presented with her small children all having 3 days of fever. It appeared they had all contracted the same viral upper respiratory infection, and after some symptomatic treatment, they too were sent on their way. Following this family was a patient with poorly controlled hypertension who presented to the ED with a headache, stating he had been out of his medication for several days and feared his blood pressure may be high. It was. He was treated and also sent home.

These are the stories I take home at the end of the day. These are the stories that keep me up at night wondering what else I could have done for those people. Yes, people. Not just patients. These aren't the stories that make the headlines. These aren't the stories my friends and family want to hear about. They want to hear about the gunshot wounds and the stabbings, the odd and out-of-the-ordinary. And I am often happy to oblige them, as there is no shortage of these stories coming through our emergency department. But this won't be Detroit's legacy. It can't be. Detroit will be rebuilt with the perseverance and fighting spirit of the everyday Detroiter.