“Are you okay?”

From the June 30, 2023 issue of the Transformational Times

“Are You Okay?” 

 Sehr Khan, MD 

 

 

In two posts, Dr. Sehr Kahn and Dr. Brady Bollinger write about their experiences with trauma, friendship, and terror ...

I’m not a hugger.  

 

I think I’ve said that for as long as I’ve lived. I don’t mean to be dramatic, but my life changed on October 18, 2022.  

 

I’ve avoided writing this for a few months (sorry Brady and Dr. Pilarski) because I thought I’d have to deal with emotions that I pushed away since the crash. Brady sent me his draft of his piece for the Transformational Times and my eyes started sweating (as one of my nurses said to me when I was in the ED after the crash). 

 

Here I am in Colectivo, writing this piece, eyeballs sweating. 

 

Love languages are interesting. What you prefer to receive isn’t always what you prefer to give. For example, I express my love through gift giving but I prefer to receive my love with quality time. Physical touch was neither here nor there prior to the crash.  

 

One of my favorite second year residents, Brady, and I had plans to go to Costco to stock our resident lounge after one of my night shifts. I had gotten both my COVID and flu vaccine that morning after shift, thinking that working the rest of my stretch of night shifts would be the hardest part of my day. Brady picked me up and we made it no less than one mile when I heard Brady yell “Sehr!”  

 

There are different ways someone can get your attention – a look, a touch, or yelling your name as if it’s the last thing you might hear. I didn’t see anything; I didn’t know what was happening. I just knew Brady sounded terrified. Brady is one of the strongest people and EM docs I know, so for him to be scared was incredibly unsettling. 

 

Brady saw a car barreling at him going over 80 mph. He had the “I think we’re going to die” thought go through his head. I did not. I sat in ignorant bliss in the passenger seat. After the impact, there were at least 15-30 seconds that neither Brady nor I could talk. 

 

When people say the wind is knocked out of you, boy is that an understatement. Brady took most of the impact since the car that crashed into us hit him on the driver’s side of the car. But instead of worrying about himself, he put a hand out to my shoulder, squeezed, just to make sure I was still there. There initially weren’t words, just touch.  

 

I didn’t realize that this moment reset something in me - in the way I choose to accept and give love. 

 

“Are you okay?” Yup we both felt okay, just sore. We sat there for a bit, trying to get our bearings. The cop that was chasing the vehicle that crashed into us came over immediately, opened my door and started talking to us. 

 

I didn’t realize how much I couldn’t breathe until he opened that door. He apologized for us being involved as innocent bystanders in a police chase. I didn’t have the energy to lecture him about the safety of police chases. I think him looking at the two of us was enough evidence that police chases suck. But we’ll save that for another writing piece.  

 

Naturally, the next thing that came out of our mouths was “We’re not going to Froedtert.” You joke about never wanting to be a patient in your own ED at your own training site. We joked about it again. And then Brady looked at me and said “I don’t feel good, Sehr. We might have to go to the hospital.” 

  

If you know me, you know I’m a control freak. I work in the emergency department; people think that it doesn’t make sense how much I need control over things. But if you’ve worked in an ER, you know it’s organized chaos. 

 

My coping mechanism has always been to try to control things because nothing makes me more uncomfortable than helplessness. In a fit of helplessness, I tried to regain some semblance of control.  

I’m the scheduling chief for my program. I opened our scheduling app, realized that Dr. Timpe, one of our Associate Program Directors, was working on Red Team. Brady and I were still sitting in the car when I called Dr. Timpe.  

 

Dr. Timpe and I work on the schedule together. He knows I’m a control freak. “Hey, Timpe, it’s Sehr.” Loooooong pause. I cried a bit because I felt scared. I felt like I was losing control. I felt helpless. It’s one thing to feel helpless in life or at work. It’s another thing to feel helpless when one of your best friends is sitting next to you and telling you that he can’t breathe, and he needs help.  

 

I’m not sure where I dug from to get the rest of the words out, but I told Dr. Timpe that Brady and I were in a bad car crash and we were coming to the ED. Brady would be a trauma alert, the highest trauma activation that occurs.  

 

My coping mechanism, AKA controlling nature, continued. Brady was taken to Froedtert immediately via EMS. I spent the next 30 minutes negotiating my arrival at the ED with EMS. I didn’t want to be taken to Froedtert by ambulance. I didn’t want to wear a c-collar (I cleared my own). 

 

Finally, after I stern text from Dr. Timpe demanding I get to the ED ASAP, and some pretty stubborn, yet great EMS providers -- as well as cops on scene who *almost* out-stubborned me -- I was in the ambulance on my way to Froedtert. I like to think we came to a collegial agreement regarding my transport.  

 

I rolled into the ED, with Dr. Timpe and Dr. Milia as well as multiple other concerned faces facing me in the triage area. I told them we’d all downgrade this trauma. Because again, control. Dr. Milia put a hand on my ankle, a grounding hand, touch that I normally don’t respond well to. But I felt safe. “Are you okay?” 

 

“Yeah, I’m good. Milia, can I just go to an arena bed?” I responded. The second “are you okay?” almost made me lose it again. I had been grasping at control, any chance I had after the crash, and I felt like I was losing it again. 

 

I was adamant I did not want to be a trauma activation. They must’ve known my stubbornness meant I was okay. But actually, they probably just realized I needed that control and autonomy for my own sanity. 

 

Dr. Timpe was the one who took care of me in ED Bed 4. The first thing he told me was that Brady was okay. The next thing he asked me was if I was okay. Again, I was given autonomy over my own care. We agreed on a hip and back x-ray, and we left it at that. I didn’t think I needed any additional imaging or labs.  

 

Luckily, Dr. Timpe felt comfortable enough with that plan and let it happen. I was discharged feeling sore, but I was able to walk out of the ER. Or hobble, your choice of words. 

 

I went to Brady’s room, and I didn’t have many words except for, “You get to hug me anytime, anywhere forever.” To which he responded, “Wow, that’s power I never knew I needed.”  

 

I initiated a hug. Can you believe it?  

 

Later that night, I ran into Dr. Milia again. We didn’t exchange too many words. But we hugged. The next day, I ran into Dr. Schroeder, one of my other favorite trauma surgeons and friends. I hugged her too. 

 

Things changed that day in October. Faster and deeper than I thought possible.  

 

As someone involved in the crash, people think Brady and I had it the hardest. The people my heart go out to, and whose trauma may not be as visible as mine and Brady’s, are people like Dr. Timpe. 

 

I can’t imagine what it feels like as an Associate Program Director to get a call like that from one of your residents, then get your mind straight, and clear out space in your pod for two of your residents to come in as patients from a bad crash. 

 

Not only that, but the other residents who were working or not, the nurses, the techs and everyone else who was either in the ED that day or heard about the crash from a text or email.   

 

After all of this, Brady asked me why I was okay, and he wasn’t. 

 

Brady understandably dealt with a level of PTSD that I was lucky enough to mostly avoid. He saw the car coming, I didn’t. He thought we were going to die; I never had that moment. He lost control over an entire situation due to the extent of his injuries, while I was allowed to keep as much control as possible thanks to my minimal injuries. 

 

People show up to emergency departments on some of their worst days. I think the main thing I’ve taken away from all this is the importance of autonomy – this idea of shared decision making. It changes the way an individual processes what happened that brought them to the ED in the first place.  

 

Clearly, I’m still processing. There are so many layers to what happened that afternoon.  

• Police chases are reckless and cause more harm than good.  
• 2016 Chevy Malibu’s are built with steel.  
• I allow and sometimes even initiate physical touch as a form of a love language.  
• The staff of our emergency department, including our trauma team, are some of the brightest people who can stay calm no matter what’s happening, or who is rolling through those doors.   
• Our residency program is filled with the most supportive residents, attendings and leadership.  
• Lastly, Brady still hasn’t been to Costco.  

 

I wasn’t a hugger before. I think you could say I am now.  

 

Dr. Khan will soon be completing her EM residency and plans to join the MCW ED faculty with a focus on injury prevention, trauma informed care and community engagement.