This is what life versus death looks like.
This is what medicine versus mortality looks like.
This is what science versus humanity looks like.
After a thoracotomy, a fellow ER doctor, Mitch Li, snapped of the spilled blood and propofol on the trauma bay floor.
Blood courses through every one of our veins to sustain life.
Propofol courses through our veins only when we're on the brink of death.
Ever since saw this picture, I have been absolutely absorbed by it. This melding of colors, texture, and story is one of the most striking representations of what we do in medicine.
Propofol, a critical drug used for sedation (with the claim to fame as the drug that killed Michael Jackson), is a milky white liquid.
Blood is a deep pulsating red that darkens as it oxidizes.
The mixture of the two -- of propofol and blood, of synthetic medicine and organic life -- intermixing on the single narrative canvas of a hospital tile floor creates a chromatic topography that is beautiful in its own right, but stunning when paired with its backstory.
A thoracotomy is a "Hail Mary" procedure performed for the severest chest injuries. During the procedure, the entire chest is slashed open, the ribs are spread apart and broken, the sternum hammered through, and the heart extracted from the thoracic cavity, all in last-resort hopes of fixing the life-taking injuries that are found along the way.
It is nasty, brutish, and cold. The survival rate of an ER thoracotomy is less than 10%.
When we perform these procedures and use these medicines, we're operating in the purgatory between life and death. Death often wins, and we're left with defeat and the infallible truth of human mortality.
On this tile floor, anarchy reigns in contrast to the methodical movements of the thoracotomy happening above it. Blood spills in complete disregard for tile borders, ripped gloves are discarded haphazardly, battling with shards of glass and specks of flesh and bone. Milky white Propofol douses the entire canvas as overhead lights shine spots on the events we most want to forget.
Life is fragile and death is crass. Our attempts to augment those truths are frequently futile. Despite defeat, we find some beauty in solace in the fact that such carnage and chaos can create small moments of art and divinity. In the backdrop of profound tragedy comes a moment of silence. A deepened appreciation of life. A reflection on greater meaning.
These revelations are subtle but poignant, ones we all need a reminder of sometimes. Sprinkled throughout our days of death and disease we sometimes find flecks of meaning. This photo reminds us of that, and we all need that reminder sometimes.
Endnote: This photograph, now titled "" can be purchased on with a percentage of proceeds going to an organization dedicated to preventing physician suicide. Full copyright to Dr. Mitch Li, used with permission.
, is an emergency physician, published writer, and national speaker on issues pertaining to healthcare with work featured in Forbes, the Chicago Tribune, NPR, KevinMD, and TEDx.