“What is your personal experience with human suffering?” he asked. Fellowship interview season. Interviewing for pulmonary and critical care, one may expect such a question. I thought I was ready for it. But the simple truth is that I didn’t really have the right answer; I probably never will.
During the morning rounds, my attending physician heaved a weary sigh: “150,000 people die every day!” Out of the blue. I quizzingly stared at him. “After my years of drudgery to maintain his quality-of-life, one of my patient of many years died today,” he said. He had a sombre expression on his face.
Of course, every day we are faced with the reality of human suffering. People say doctors get insensible to suffering from being exposed to decay and disease. Obdurate to viewing patients as a collection of symptoms and numbers rather than human beings.
I remember once, after losing a young patient to complications of acute severe mitral regurgitation, I saw the intensivist holding his head with both his hands, crouching on the chair, head hanging between his legs, staring at the floor agonising for what seemed like an eternity. The patient had just been coded for almost an hour. He dolefully talks about it, months later — even today.
“Mm-hmm?” looking at my screen.
“Patient in 2529 has died.”
I go and pronounce my patient. Some other day life would go on, but not today. Mr. D, after fighting a hard battle, had chosen to die with only comfort measures and dignity. Happens all the time, doesn’t it? But your heart is a little more heavier every single time. It eats at you. That day in between patients, procedures, rounds, family discussions, nurse’s requests and staring at computers, I found myself crying in private in the bathroom. It finally got me.
A photograph of an ER physician crying crouched down outside the ER for his 19-year-old patient who had just died had gone viral a few months ago. Facebook likes and shares in the thousands.
These examples show a side of us that our patients don’t usually see. Isn’t it hard to tell a father that his only son is dead? Never is a medical student actually taught to deal with loss or to deal with grief. And everyone experiences grief in a different way, especially doctors. But the point is everyone does experience grief.
What people fail to realize is that we compose ourselves — walk into the next patient’s room — introduce ourselves with a smile and a handshake and sometimes to thankless and unappreciative crowds too. Being a doctor doesn’t grant us magical powers to cope with loss, but it can teach us the necessity of conscious living. It allows us to witness miracles.
Even during periods of grief, burnout and exhaustion one can never have enough compassion or empathy.
My two cents worth to my colleagues is based on this: There is an incurable idiosyncrasy between grief and the human perception of it. One of my mentors used to say that if the glass breaks, the Buddhists would say that the glass was already broken, but it is now that you have found out about it.
I went to medical school because I believed that if I work hard, I could be of use to people at their greatest times of need. As they say, the show must go on.
Dhruv Desai is an internal medicine resident.
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