I had not planned to leave the Emergency Department.

Because – of course – why would I?

Whatever wiring it is in my brain that drives me, ceaselessly, to seek to care for those in the worst moments of their lives, it found relief and fulfillment in a trauma bay, in a resuscitation room, in the chaos and the noise and the absurdity.

Wherever I wandered in the country, in the world, the radar screen in my soul searched for the ping of those drowning in their suffering.  I was, inexorably, drawn to it.  

Let me help, was the perpetual response.  I can shoulder the weight; I can bear the burden of your grief and fear.

And I could.  And I did.

*

But interestingly, about ten years ago on a hotel balcony overlooking the ocean in the Philippines, I thought I’d encountered something I Could Not Bear.

We were a small group that had flown through Manila to the Visayas in the aftermath of Typhoon Yolanda.  We worked with a group of incredible Filipino nurses to try to provide very basic medical care to small towns, meeting under the skeletons of buildings, each roof having been ripped away and tossed into the void by winds of more than 140 miles per hour.

But we were poorly organized, small, underfunded, and impulsive, and after our trip leader refused to spend the organization’s money on albendazole (cheap, effective, requested by the people we saw, but not an “emergency” medication), half of us packed up, found a hotel in Iloilo City, and got ready to head back to the States in disgust.

On the balcony, one of the physicians asked me if I was interested in working with him in Africa.  

The top of my head nearly came off.  I had been waiting for an opportunity to work in Africa since I was twenty; the idea of humanitarian work there had successfully driven me back to college after spectacularly failing out at age 18.

I had a powerful white-savior complex, and it would persist, humiliatingly, unrecognized for yet another eight years after that.

“Oh, gosh, yes,” I replied, incredibly excited.  “What kind of work are you doing?”

“We’re based in Malawi,” he said.  “We’re helping take care of children who have been sexually assaulted.”

*

I didn’t think I could do it.  That was the bottom line.

I could not even wrap my head around the idea of caring for children with that kind of trauma.  I almost couldn’t conceptualize it. I recognized, intellectually, that it existed, but the idea that someone could torture a small child for pleasure or profit immediately sent my emotional self into flat-out denial.

I did not think I could shoulder such weight.

How could a world exist where things like that happened?

*

Interestingly, about five years ago, I stood in the hallway of my hospital and verbally tore into a mid-level provider.  

He had wondered, out loud, at the nurses station, why the nine-year-old I was currently caring for would tell such lies about being sexually abused by her mom’s boyfriend.

More than a minute later, with me still raging at him in quiet, furious tones for believing a rapist over a child, he backed down and raised his hands, apologizing.

“I’m sorry – I just – I can’t — I mean, I just don’t want to believe it’s true.”

*

Once back from the Philippines, the doctor and I stayed in touch.  We had a few more e-mail conversations, but I distanced myself from his work by pleading ignorance — I’d had no training in caring for adult survivors of rape and assault, nevermind children.  I didn’t know what I was doing, and I didn’t think I could help.

That opportunity flickered like a candle fighting a typhoon, and then disappeared in a tiny puff of smoke.

*

Two weeks ago, I sat down with the manager of my Emergency Department, and gave my notice.

And tomorrow I start orientation for my new job, working with the largest Abuse and Trauma center in our state, getting ready to teach the next generation of Sexual Assault Nurse Examiners.  

I’m a SANE Trainer, paired in this wild endeavor with one of my best friends.

40-hour courses on adult and adolescent care.  40-hour courses on caring for children.  Advanced SANE classes, refresher courses, case reviews.  Whatever we can create, whoever we can reach, we’ll travel the state, and we’ll teach other nurses to care for survivors.

And, quietly, on the days where I’m not in a classroom or a zoom meeting, I’ll still be on-call for the small hospital in the next county south, for the large hospital an hour away.

Because no matter how much we wish it weren’t true, no matter how much we wish it didn’t happen, rape and sexual assault and child abuse and domestic violence and non-fatal strangulation persist, in our small towns, big cities, in our neighbor’s home.

And there still aren’t nearly enough Forensic Nurses to care for the shattered lives left behind.

*

I emptied my locker and snuck out the back door of our Emergency Department last week, quietly, without saying good-bye.

It was partly because I still believe that the stars will align here in my hometown and allow me to continue working with survivors, to continue providing care right here in my own community.

But it was partly because I haven’t yet reconciled myself to the idea of leaving the ED.

How do I walk away from the past fifteen years of my life?  How do I step away from something that I know inside and out, something I know I can do, something that makes me laugh and rage and yell and cry, something I can – and do – excel at?

I don’t know.

But I DO know that every time in my life I’ve been given the chance to change, to fling myself into a new raging river, to go somewhere I’ve never been, try something I’ve never done, make myself profoundly uncomfortable and itchy in a brand-new skin, I have emerged a better person in a fuller life.

So, I guess, the answer is:  I don’t walk away.

I jump.