Experience of a Young LDS Doctor

September 30, 2004 | 20 comments
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Andrew Florence, a friend of mine doing an ER residency, emailed a journal entry to some of his friends. He has given me permission to post it here:

This morning I cried for the second time during residency. Neither time has been in the ER. The first time was last spring as I saw a family in tears, surrounding their 17-year-old daughter’s bed in the surgical intensive care unit, having just heard the official declaration that she was brain dead, and now faced with the previously abstract concept of organ donation.

She died in a head-on collision caused by my other patient down the hall who lost sight of the road as she reached down to pick up the cheeseburger that had fallen off her seat. Not yet knowing the irreversible tragedy caused by this momentary act we’ve all committed, her primary concern, aside from her broken ankle, was whether I could salvage the eyebrow ring I’d just removed from her swollen brow, “since [she’d] only had it in for a week and didn’t want it to grow in.”

Last week I walked into a room knowing only that the patient’s chief complaint was assault by boyfriend. There I met a very pleasant, yet physically and emotionally traumatized young woman accompanied by her mother. She had a swollen black eye, multiple facial contusions, and hand-shaped bruises around her neck consistent with attempted strangulation. Despite her painful looking appearance, she was stable and seemed to have sustained no permanent damage. She explained the circumstances. Her boyfriend, who lives with her and her mother and her step-grandfather, had come home from work only a few hours after she had dropped him off, and found her doing her nails getting ready for the day. He screamed at her, accused her of cheating on him and began to assault her. He beat her in the face and held her down. As she finally broke free he pulled at her but she was able to run out of the house and down the street only partially clothed.

Not knowing much more than this I felt like I could almost profile him. Was she cheating? No. Was he? Most likely, and was now projecting his guilt on her. I asked if he had a criminal history. Yes, something drug related. Does he still do drugs? He quit. My guess is he’s back into them pretty heavily and is again projecting his guilt and desperation on her. Has he ever hit her before? No, but he is verbally abusive and very controlling. Mom standing nearby had not witnessed this behavior, she said he had always seemed to come off clean. He did have a job and was paying a portion of the rent. These facts surprised me as working in the ER has introduced me to a generation of free-riding parasitic males who do nothing but create work for society as a whole, usually living off welfare girlfriends doing drugs, playing videogames, spreading STDs and assaulting people.

I spent quite a while talking to her and her concerned mother about what today’s events meant. I told her I thought she needed to cut all ties with this man. Fortunately they didn’t have any children together, so she could completely rid herself of him. She was very receptive and agreed it was the thing to do. She had filed a police report. It shocks me how many of these women refuse to condemn these criminals for whatever incomprehensible reason. I guaranteed her that he would never change. I’m okay with being wrong in that guarantee, I’d rather err on the safe side. I’m generally an optimist and believe strongly in our power to change for the better. Domestic violence, however, is one area where I just don’t believe in second chances. I just don’t think they are capable of changing. Do I believe in forgiveness? Yes, but never again in person.

I really felt like we had a good interaction. I sensed that she felt listened to and I could tell she trusted me. She left the emergency department smiling. She seemed strong and optimistic. I committed her one last time to follow up with the police and see that she take precautions that this not happen again. I hadn’t really thought too much about her and her mom since and I wouldn’t have been able to come up with her name.

As I opened the Sunday paper today, a headline caught my eye, so I turned to the front page of the metro section. “Suspect held in triple slaying.” For some reason my first thought was, “I wonder if that suspect has ever been my patient.” So many of our patients are in and out of jail, I wondered if I would recognize the name. The picture above showed two medical examiners wheeling a bright blue body bag across the street. As I read below, I recognized a name, but not of the suspect. It took a few seconds to piece things together. “For nine anxious days, 26-year-old Trudy Murrow had feared that her ex-boyfriend would finish off his earlier attempts to kill her. He went beyond that, police said Saturday, to fatally stab her, her mother and her step-grandfather at their north Minneapolis home late Friday.”

The paper reported that he had lived with the family until he beat her up on September 1. That was the day I met her. Since then, he had apparently raped and kidnapped her at knifepoint and had eluded police several times. I turned the page and recognized photos of Trudy and her mother. “On Friday night, just before the slayings, a friend visited Trudy and her family. Trudy felt just a little better because Jones hadn’t called her all day. They were repainting her room, trying to make her comfortable. She was going to throw her old bed away and try to forget what had happened.”

The police chief said, “Sometimes at the end of the day, you still can’t prevent something from happening, that’s why our thoughts and prayers go out to the family.”

I’d never met a murder victim before. I’d never sat with two murder victims and gotten to know them a little bit and sent them on their way. How do you sit with a mother and daughter and give them advice on avoiding a dangerous situation, only to find out that they had followed it perfectly and it did nothing for them? Just nine days before they were stabbed to death in their home we talked of a brighter future. I had looked over every inch of Trudy’s body to see if she had any lasting injuries. She didn’t.

As I sat there with the newspaper in my hands, Abigail looked up at me with her big three-year-old eyes and said, “Why are you sad Daddy?” I didn’t really know what to say. I told her, “Because one of my patients from the hospital died. I tried to help her but she died anyway.” She tried to comfort me and asked me if I wanted to see her picture of a “sad building.” She has been very curious about a picture we showed her yesterday, on the anniversary of September 11th, of her as an infant in Elizabeth’s arms as we stood in front of the gaping black hole in the crippled Pentagon, a mile from our old home.

I have been thinking about Trudy and her mother all day. I don’t really know how to describe my thoughts. Although I know I will never forget this, I can’t really tell what impact it will have on me. After all, already this week I had to tell a mother, surrounded by emotional and quite dramatic family members, that her 27-year-old son was indeed brain dead, as could be expected after he shot himself in the head during a standoff with police.

But like I said, I have only cried twice so far in my residency.

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20 Responses to Experience of a Young LDS Doctor

  1. Geoff B on September 30, 2004 at 5:30 am

    Wow. What a story. Well written and very moving. Thanks for posting it.

  2. danithew on September 30, 2004 at 7:12 am

    Thanks Matt.

    What an amazing post.

    My wife is about to apply for pediatric residency programs. She just had a rotation where she worked with abused and neglected children. She saw some kids who were severely beaten by relatives or assigned caregivers — at least one of which was comatose as a result. Not only did she help to care for the patients, but also assisted authorities (and in at least one case the FBI) to photograph the victim injuries so that evidence could be provided at trial.

    The types of experiences shared by the post and that my wife has related to me bolster my desire to see more LDS doctors (or doctors in general) participating in the blogosphere. Medical doctors often have amazing experiences and insights to share.

  3. a random John on September 30, 2004 at 7:35 am

    danithew,

    I would guess that the great majority of LDS residents don’t have time to blog during residency. I know my wife doesn’t. It is 7:30 am and she has already been gone for two hours. When she gets home she wants to spend time with our son and study. She has had some amazing experiences during residency which I am sure she could share much better than I could if she had the time. I know that coming off or her ER rotation he main concern was that our children never get on a motorcycle (I didn’t know the term “degloved hand” or worse “degloved penis” before she brought home accounts of having treated such things) and they are not to participate in the rodeo.

  4. Ryan Bell on September 30, 2004 at 10:10 am

    Andrew, if you’re reading this, and I know you are, thanks again for that story. It’s provocative in many ways. And congrats on breaking into the bloggernacle. Why not stick around now that you’re here?

  5. Nathan Tolman on September 30, 2004 at 10:49 am

    For all my complaints about working in the Ivory Tower, I guess there are some benefits. I never see stuff like this.

  6. Austin Frost on September 30, 2004 at 6:58 pm

    When are males going to get it? My unscientific belief is that many of the social ills of the US could be avoided if we exterminated the violent tendencies that are fairly common among males. I am generally opposed to the death penalty, but I wouldn’t regret ridding the earth of men like CC’s boyfriend, but perhaps I’m caught up in the emotion of the journal entry.

  7. ronin on September 30, 2004 at 8:54 pm

    Well, I am not a physician, but, given my chronic halth issues, I have spent a fair amount of time at the Univ of michigan’s Er, and unfortunately, I have seen stuff like what Andrew writes about. Once, I even saw a loser, drug addicted, parasite of a boyfriend, who had eluded t he police, come into the ER, where his injured girlfriend was, attempting to beat her up some more.

  8. Philocrites on October 1, 2004 at 4:33 pm

    This is a purely technical comment for the site managers: I read Times & Seasons using Safari for Mac OS X, which seems especially picky about {blockquote} tags. Because this entry has the {blockquote} tag on the front page of the site, but the {/blockquote} tag is only on the individual entry page, the unclosed tag wreaks havoc with the sidebar on the front page. It’s now obscuring half of every post! The simple way to address this is to put an {/blockquote} tag at the end of the inital part of the entry and a {blockquote} tag at the start of the extended entry.

  9. clark on October 1, 2004 at 4:37 pm

    Ah, it was the blockquote! I was trying to figure out what was causing that yesterday.

    Let me second the request that folks test their pages under Safari. In general IE is very buggy in how it displays things. Typically you shouldn’t use blockquotes anyway when possible. Use a custom paragraph style. (On my site I changed things so that all blockquotes in comments are translated to paragraphs with a custom style)

    BTW – Philocrites, do you have problem with the comment hack some people are using with Blogger? It causes Safari to go nutso with me, constantly reloading the page.

  10. Kaimi on October 1, 2004 at 6:14 pm

    Is that better, guys?

  11. William Morris on October 1, 2004 at 6:51 pm

    Clark:

    You know, I checked out my blog with Safari and didn’t notice the same problem. The hack didn’t work fully as the names of the commenters weren’t displayed [they all said anonymous — which I realize is how they are registered with Blogger], but I didn’t experience the reloading problem you are describing [that would explain, however, the sudden jump in hits to my site on Tues. or Wed. — the hits were above 400, but the unique visitors were my standard, modest 35-45 range].

  12. a random John on October 1, 2004 at 7:53 pm

    Nathan,

    I am not sure that being isolated from “stuff like this” in an Ivory Tower is a good thing. It isolates you from the bad stuff but also isolates you from helping someone in such a situation as well.

  13. Clark Goble on October 1, 2004 at 8:54 pm

    That seems to have fixed it Kaimi. Thanks.

    William, what version of Safari were you using? I’m running the latest and, to be honest, it was a step back in several ways. I’m running Safari 1.2.3 under OSX 10.3.5.

  14. Dasha on October 26, 2004 at 3:07 pm

    I happened to stumble onto your entry as I was researching Casandra’s murder for the project I am doing for my organization, which works on domestic violence policy/legislative issues. I am so sorry for the pain you are feeling after Casandra’s tragic murder. I can’t even imagine how great it is.

    A quick question for you… Does the hospital where you work have a domestic violence program associated with it or any advocates who work? Or is there any training for the ER staff on domestic violence? I know that several Twin Cities hospitals do, including the Fairview hospitals, Methodist, North Memorial, and United. You totally did the right thing to talk to Casandra about leaving her abuser and I’m glad you did. But an important component of talking to a victim of abuse is finding the safest way possible to leave. Training on domestic violence or even reading some information can be an important step. If there isn’t a training program at your hospital, you might want to check out the web page of the MN Coalition for Battered Women at http://www.mcbw.org to find the battered women’s program closest to you so that you could call them and see about having them work with your staff on learning to work with abuse victims to find safe alternatives to domestic violence. They also have good handouts on battered women’s issues.

    This isn’t, IN ANY WAY AT ALL, to cast any blame on you for how you handled working with Casandra. For all I know, you did offer her some domestic violence resources besides filing a police report. And even if you didn’t, if you haven’t had any or much training, you wouldn’t be aware of the importance of safety planning and resources with abuse victims. Either way, you did the best you could and, most importantly, you offered Casandra and her mother your compassion and your kindness, which is a whole lot.

    I wish you the best.

  15. Dasha on October 26, 2004 at 3:08 pm

    Ooops, that was meant for Andrew. Perhaps I should read more closely. I’d be very grateful if you could pass it along.

  16. me on December 30, 2004 at 7:12 pm

    Matt,
    I thank you for taking interest in this story. Casandra, my cousin, Aunt Renee and Grandpa are a huge loss to our family. I hope that others will read this and be aware of the signs whether you’re on one side of the fence or the other.

  17. DB on January 21, 2005 at 1:11 am

    I have a lot of emotions still after these few months. I have been a victim of the murderer and we have a baby girl together. I met Casandra once, and she confided that he was a liar. I noted that it will only get worse. When I seen her picture on the news there was no sound. I immediately remembered her from somewhere. I called my neighbor and asked her if she could recall what Casandra looked like; she came over and I was flipping channels frantically to see what was wrong or if that was even her. I knew that if it was Casandra, it would not be good. Unfortunatley it was and I totally fell apart, it was despair and fear and all the shock of my life that he was capable of all that I feared. THere was no question in my mind that he didn’t do it. He threatened me and my family as well; I could not believe this woman went through the same thing as me and I lived. I felt guilty. I then started feeling sorry for my daughter who knows nothing of him. What do I tell her when she starts asking? The truth? Should I tell her he is dead? I cried so much for the next few weeks, in disbelief of how and what a person endures in the last moments of a violent exit. These people did not deserve to die; but I feel connected to Casandra for living the hell of being his girlfriend and the fear of leaving. I testified against him for the indictment. The prosecutors wanted to know what I went through; it was painful and humiliating. But I did it for Casandra and I. A days before, I had a dream that she and I was sitting on a couch and we were talking about good things and laughing. She told me to be strong and held my hand; I kept telling her that I need her by my side.

    When I sat infront of the secret proceeding, it seemed like all my anxieties exited my body. Afterwards I felt better, knowing that my statements will have some sort of impact against him.
    To the Author of this article:
    Thank you so much for sharing your heart and thoughts.
    A survivor

  18. Matt Evans on January 21, 2005 at 1:20 am

    Dear DB,

    I am so sorry for what you have experienced and what you are now going through. I pray that God will bless you and strengthen you and help you raise your beautiful daughter to be wise and good and strong. Thank you for sharing your feelings with us.

  19. Cheri Current on January 26, 2005 at 6:44 pm

    Matt,
    Thank you for this story. It means alot to the family. I’m glad you were blessed to have met my cousin and auntie. It’s nice to know there are doctors that care so much, that go beyond their duty. I really hope this story helps other women realize the tragic consequences that are very possible.Thanks Again and God bless you and your family!!

  20. Andrew on January 27, 2005 at 1:50 pm

    Several months later it is surprising to find new responses on this web site, especially from Cassandra’s own family and friends. It is nice to make a connection with you, I am sorry about this tragedy. I had originally written this as sort of a journal entry and then shared it with a few people. I never would have thought it would get back to her family. Feel free to email me at: agf (at) georgetown.edu
    Thanks, Andrew