In the neonatal ICU, a baby dies from necrotizing enterocolitis or NEC. It’s not the first, nor the last time I’ll experience death during my medical career. Doctors, nurses, respiratory therapists, surgeons, and the rest of the team spent the days prior to his death, implementing medical interventions and procedures hoping to arrest the process. Two surgeries, multiple blood transfusions, antibiotics, drips to support the blood pressure, intubation and ventilator support were administered to no avail.
Despite it all, the baby died. His death gave life to a plethora of feelings that had nowhere to go.
A few hours later, the team was called to a debriefing. Debriefings benefit the team. It’s a time for the team to share feelings, express grief, and allow for closure before moving on. However, lacking leadership and structure, the objectives were unmet.
Support was not to be had that day—a missed opportunity.
Instead, I had to move on to the next patient carrying the weight of losing a patient, and the heaviness of a support service gone wrong. It was the last debriefing I’d attend for a while.
The pattern is common for physicians, residents, and med students. We see things and experience human vulnerabilities and frailties with only the context of our own coping mechanisms and skills to process it.
We walk the journey alone, trying to figure it out and find meaning in the injuries and the wounds, the illness, and the pain our patients experience, and at times, we feel as well.
Support is elusive.
It becomes ingrained in us to just move on to the next patient in silence.
Putting it in practice: Defining support on your journey in medicine
Fast forward. I’m the attending now. A resident approaches me to discuss the events around a baby who had passed away. Tears are still evident in her eyes.
Do I continue the cycle of “support” that I received during my training? Or do I use the acquired knowledge from the coaching arena to supplement the gaps left by medical school and training to provide her with the support she needs? I provide her with what she needs to move on and see the rest of her patients with a heart and mind that is finding peace. The journey continues.
What does support in medicine look like when people are put through the rigors of extensive course work to build their medical knowledge, have to compete at levels that turn friends into competitors, and then serve patients at their most vulnerable all while believing we must keep our own humanity in check.
The right support:
- Acknowledges the experiences and the feelings of the physician, resident, or medical student.
- Validates their feelings in a nonjudgmental and non-critical manner.
- Explores what the desired outcome might be.
- Offers the physician a way to shift the energy around the experience.
- Creates a safe space to sit and relax back into their humanity with grace.
- Provide future opportunities for ongoing support.
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