I’m not sad – I’m numb.

My friend, a seasoned internal medicine resident, revealed a chilling truth after grappling with eight patient codes – three lives eluded salvation. The gravity of his words froze me. When did the mourning for human existence transform into a necessity to numb our very core? I found myself pondering the onset of this desensitization, this “numbing.”

I thought back to my own experiences as a third-year medical student. The mournful rhythm of raindrops tapping against my window echoed the haunting beeps of the hospital monitors. Instead of the comforting hum of a human voice, it was the clinical beeping that signaled the presence of another soul in need. This realization struck me during my initial experiences in the operating room, where the fear of the unknown loomed large.

As I stepped into my very first case, a faceless patient lay supine, their abdominal canvas laid bare for the surgeon’s artistry. A scene reminiscent of a horror film unfolded before me as the surgeon, his face shield already adorned with splatters of blood, turned to my classmate and me, gesturing to the cold metal retractors awaiting our touch. It was my classmate’s final day in the operating room and my initiation into this surreal theatre of medicine. She, a seasoned hand, seamlessly joined the ballet of the procedure without a spoken word. In contrast, I stood frozen, entangled in a web of questions. “What did he look like? Who is this person? What is his story?”

Sensing my uncertainty, the surgeon abruptly seized my hand, thrusting it into the void within the human cavity. My hands shook as I felt the smoothness of the small intestine, realizing the privilege of being able to feel a part of a person that they themselves will never feel. Wordlessly, the surgeon placed in my hands a substantial mass he had resected, a weight that would later come to haunt me. As the surgery concluded and my classmate meticulously closed the surgical puzzle, I shed my scrubs and surveyed the operating room. Witnessing the team cleanse the patient and prepare him for post-op felt like the stagehands seamlessly changing the background for another scene. I finally glimpsed the obscured face. I bowed my head and whispered a reverent thank you to the patient, still asleep.

Sharing this revelation with my classmate, she gawked. She did not share the same sentiment. She, like many of my classmates, viewed these experiences as “part of becoming a physician,” boxes to check to graduate. She elaborated on the dehumanization inherent in the operating room – a defense mechanism meant to erect a barrier between the human and the humane, shielding health care professionals from emotional inundation. This experience felt like a once-in-a-lifetime opportunity, such a privilege, and yet I was doomed to repeat it over and over again until I, too, became numb. Upon returning home past midnight, tears flowed freely.

In the following week, pathology results arrived for the mass we resected, and they were grim. It was now our task to relay the information. As the surgery team scrambled for an interpreter, I listened to the patient’s monitor’s quiet beeps. Witnessing the surgical team deliver the news, I hung my head in despair. But the patient did not. With unwavering resolve, he raised his chin, locking eyes with his weeping wife and daughter. In the face of imminent mortality, he deemed himself fortunate, cradling their love and placing trust in a higher power. He smiled tenderly at the love he cultivated and turned to us to express his appreciation for our care of him. Here lay a man, weakened by surgery, tethered to tubes and drains, yet resilient enough to inspire and express gratitude amid a room reverberating with mixed emotions. This time, I thanked the patient without whispering.

I’m not sad – I’m numb.

Would I, too, succumb to numbness? Perhaps it shields us, allowing us to show up for our patients without faltering in the delicate dance of life and death. Mindful that excessive shielding might inadvertently turn protection into apathy. Yet, in all the sterility, I still craved the human touch. I yearned to feel sadness, happiness, and emotion with my patients. I vowed never to miss an opportunity to hold a patient’s hand, whether in the clinic or before a procedure, acknowledging the tapestry of our shared journey through life – woven with threads of vulnerability, resilience, and profound interconnectedness.

And I refuse to numb myself to it.

Katayun Fethat is a medical student.