On most mornings after a night shift in the ER the doctor did not feel as though a great burden had been lifted. The morning of 9/11/02 was different, however, because he had finally stopped grieving for the thousands of victims of the terrorist attacks of 9/11/01.

He had not known how he would ever do that, having grieved for them for the previous 364 days, but in the end it was simple, really; he just stopped. He stopped grieving, and he stopped worrying about terrorism as any more of a threat to those he loved than any other chance in a million. He was not cold-hearted, did not lack compassion, was not unpatriotic, but he was done.

The answer to the question of how to stop feeling that way had come to him in the ER, a place where he often found what he needed from meeting the needs of others. He had worked through the night that became 9/11/02, and before the 13-hour shift was over had dictated the words “Nine Eleven” or written “9/11,” more than 50 times. Each and every time had been like touching an emotional hot stove. In the early hours of that morning, however, while calling up the ghosts and ghastly images over and over again with each repetition, he found that the way out of grief for the thousands was in moments of compassion for the few.

In the ER that night there were many in need of his compassion. There was the girl of 4 whose parents were in the midst of a bitter divorce and who might be the victim of sexual abuse. She was beautiful, sweet and innocent, as only a child can be, but he suspected there would be much to grieve about her life before it is over.

There was the man with the self-inflicted gashes on his forearms, gashes he carved into his own skin because somehow the pain of the cutting relieved the pain of his tormented mind. Old cuts surrounded the new cuts, each a jagged line of his sad story written in scar tissue and blood. The doctor was sure the man’s life began with a childhood which produced memories that cut like broken glass.

There was the boy who had fallen 15 feet onto his head, suffering a broken nose and a concussion. He was quiet during his tests and his time in the ER, as though he knew that something terrible had almost happened to him. His parents suffered from the grief of knowing he could have been killed, and the pain on their faces reminded the doctor of the grief of other parents he had known who had not been so lucky.

There was the girl of 16 who came in crying with belly pain. She was homeless and had not eaten much of anything for the past four days. The doctor finally figured out what was causing her the pain when he thought of her as the child she was; she was hungry, and desperate children cry when they are hungry because their stomachs ache. What had happened that put her on the street and deprived her of food? Who knew – in the ER there is time only for the problems you can treat in lives you cannot fix, and for the grief that comes with exposure to suffering you cannot end with a test, a splint, a bandage, ”

or even the best medicines. Next…

There was another girl of 16, this one with a urinary infection probably caused by sexual intercourse. She was younger than his oldest daughter and not much older than his youngest daughter, and too young, he thought, for the life of a 20-year-old at the age of 16. He wondered what was missing in her life that she needed to fill it with a lover at that early age, but it was just another question he did not ask about a problem he could not fix.

Finally, there was the woman in her 60s suffering from her first stroke. She had smoked for years, and now had paid the piper handsomely; the stroke had caused the left side of her face to droop, destroying the symmetry of her smile.

Somewhere in the early hours of the morning the doctor suddenly realized that if he continued to feel the pain of his patients of 9/11/02 and that of the victims of 9/11/01, together it would all be too much to bear. He could not continue to be a caring physician on 9/11/02 and carry forever his grief of 9/11/01. Over the years in the ER he had seen what human carnage looks like, and that had brought him too close to the unimaginable realities of the World Trade Center, the Pentagon and the field in Pennsylvania. He had been so close to faces of grief in the ER over the years that their pain has washed over him many times. If he continued to carry grief for the victims of 9/11/01 he could not carry grief for any one else, and would have no compassion left for the patients of the next shift.

So the doctor walked out of the ER on the bright morning of 9/11/02, said goodbye to the victims of 9/11/01 and said he had to move on. He would grieve them no longer, but remember them forever.

Erik Steele, D.O. is a physician in Bangor, an administrator at Eastern Maine Medical Center, and is on the staff of several hospital emergency rooms in the region.