I serve as an emergency physician in the emergency department of a Level 1 trauma center. In urgent scenarios where trauma cases arrive in the ED, patients are momentarily designated as Doe – either John or Jane – due to the immediacy of their situation and the necessity for swift care. To guarantee distinct identification, extra descriptors such as random terms, colors, call signs, or animals are added to the Doe, along with a sequential number. Therefore, a patient’s identifier might appear as John DoeChameleon231, acting as their sole ID during their hospital stay until they are discharged. In the meantime, their real name is securely connected within the medical record for post-discharge activities, including prescriptions and follow-up care. Importantly, every trauma patient is assigned an arbitrary birthdate of 01/01/1880 for uniformity, a puzzling detail considering that no living patients could have been born in that year.

Today, I attended to a Doe with severe injuries – fractures in the head, face, neck, and leg, as well as considerable internal damage. The patient, located by EMS on a roadside, provided us with no background information. Urgent surgery was necessary for internal bleeding, while the cerebral hemorrhage was already inflicting irreversible harm. The cervical injury required stabilization, but the extent of the damage did not permit immediate surgical repair, whereas their fractured leg, which could be fixed with orthopedic intervention, appeared trivial compared to the likelihood of enduring disability. In such situations, my attention is directed solely at addressing the visible injuries while collaborating with my colleagues to ascertain further required actions.

When reflecting on cases like these, I experience a deep sense of sorrow, recognizing the constraints of even the most proficient medical treatments. These instances remain on my mind – not stemming from a feeling of personal inadequacy, but as chances for development and insight. These nameless Does, documented with an improbable birthdate, become part of my personal story, perhaps leaving a deeper mark in my memories than they will within their lifetimes.