I remember so clearly all of the idealistic optimism I felt at the beginning of medical school: the naïve certainty that I was going to help people and save their lives... and I would do that through the power of love. Yes, I came to medicine with the awareness that love is actually the force that heals and I was determined to bring my knowledge of love to medical practice. It was going to be miraculous.
And I remember just as clearly the day when all of my idealism came crashing down around my feet, in my Waterloo moment, leaving me disillusioned and bereft. On that particular morning I was working in the emergency room as a fourth-year medical student when a trauma patient was brought in by ambulance.
She had been in an auto accident and had been ejected through the windshield because she wasn't wearing a seatbelt. We soon learned that she was just 16 years old and had been on her way to school, driving her best friend in the car she had received for her birthday just a few months before.
She had massive injuries to her head and neck, and the ER trauma team moved in quickly to begin resuscitation. I was assigned to help with chest compressions, monitor IV fluids and stay out of everyone else's way. In a blur of urgent yet efficient activity, dozens of people worked on the girl, performing their roles in this well-choreographed death-defying dance.
I helped wherever I was needed and watched and waited... for the miracle to occur. We were going to save her. This incredible super team of highly-skilled technicians with an endless supply of catheters, wires, tubes, syringes, plasma, defibrillator paddles. She was only 16 -- just a few years younger than me. She would not die. We wouldn't let her go. I wouldn't let her go... I had love on my side after all. We just had to allow enough time for the miracle.
We worked on her for what seemed like an entire day, yet it may have been only an hour. One by one the technicians withdrew and left the little cubicle where the miracle was yet to take place. I stayed through everything, holding her hand, sending her all the love I could muster, believing... believing... she will not die.
But she did. The nurse removed all the tubing and wires and covered her lovely young face and curly blond, blood-caked hair with a clean sheet. We were giving up on the miracle. We were giving up on love.
I was devastated and broken apart -- all of this intense, focused effort had been for just one purpose: to save her life. And now, just like that, we were giving up. I stood there speechless trying to comprehend what had gone wrong -- did I not send enough love to her? Had I not believed strongly enough in the possibility of a miracle?
I wandered around the ER, trying to find someone to talk to about what had just happened, but the resident and attending were already working with other patients, the nurses were writing their notes and the orderlies were cleaning up, getting the cubicle ready for someone else. No one looked at me. No one noticed my pain. No one talked to me... ever... about the death of that girl, or about the death of any patient.
I went home that night and fell on my bed, exhausted and numb. When I tried to kick my shoes off I found that, for some reason, they were stuck on my feet and I had to struggle to remove them. Then I looked inside and saw that they were filled with dried blood -- the blood of the young girl had dripped down underneath the drape sheet while I held her hand, slowly filling my shoes without my awareness.
I crumpled onto the floor of my bedroom and sobbed and sobbed, holding onto those shoes that I would never wear again. I pictured the face of that beautiful girl, lying serenely on the gurney while her life slipped through our hands and her blood dripped into my shoes.
I understood in that moment for the first time the weight of the responsibility I was taking on my shoulders... on my heart... by becoming a doctor. The pain of losing that patient was overwhelming and the sorrow from the failed miracle was so immense it could drown me. I knew then that medicine would always be a life and death struggle... for the patient... and also for me. And I was no longer certain how it would turn out in the end. Miracles were suddenly hard to come by.
Many years later I was in a different hospital at 2 o'clock one morning, waiting for the elevator to take me upstairs to examine a baby that had just been born by C-section. As the doors opened I saw in the corner one of my colleagues, a prominent cardiovascular surgeon in our community, the original "Dr. McDreamy" -- handsome, brilliant, cocky, rich, infallible.
But he was hunched over with his face in his hands, sobbing uncontrollably when I stepped inside. "Steve, are you okay?" I asked, wondering if some tragedy had struck his family. When he realized that he was no longer alone, Steve quickly straightened up and suppressed his sobs.
He told me he had just finished seven hours in the operating room, trying to save a 29-year-old woman who had come in with major chest trauma. He had done everything he could to repair the damage and save her life. But there had been no miracle. There was nothing to show for his dedication and perseverance that night.
I understood his feelings precisely in that moment. "I know," I said softly, "I know how it feels." We rode in silence, each bearing the pain of our own memories... of so many heroic attempts and senseless losses. Of so many shattered miracles and broken beliefs.
There was little comfort for either of us in that moment as we each bore up under our pain, firmed our shoulders and looked straight ahead. Though we were both traveling through the path of grief, it was a solitary journey that no one, not even a colleague, could share.
Then the doors opened and we each walked away to our own worlds. There were more patients to see... more lives to touch... more fragile miracles to breathe life into... and to helplessly watch slip through our well-trained hands.
Dr. Karen Wyatt is a hospice and family physician and the author of the award-winning book "What Really Matters: 7 Lessons for Living from the Stories of the Dying." She is a frequent keynote speaker and radio show guest whose profound teachings have helped many find their way through the difficult times of life. Learn more about her work at www.karenwyattmd.com.
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