Recent essays have shed light on the Herculean task of maintaining humanism in medicine in the face of added responsibility during residency and the seemingly inevitable cynicism embroiled in patient care. The solution appears to be rooted in active reflection on the process of training and clinical practice and recognition of what it is that brought us here.
In this moment of active reflection, I contend that you have a superpower
Clark Kent was born with his. For Peter Parker, it arose from the bite of a spider. For Bruce Wayne, it was the death of his parents and the strength of his conviction.
Your superpower is a little different though. It’s been in the making for quite some time. You’ve been picking it up in forgotten classroom activities, between the pages of textbooks and paperbacks, and in silent breaks in conversation.
What is this unrecognized, extraordinary ability of yours? It’s what coalesces at the intersection of your medical knowledge and your humanity: a profound sense of empathy.
Consider the following: At any given moment, you can talk to your patient and zoom down to the cellular level, ducking beneath kinesin as it marches across microtubule freeways, then out against the walls of the pericardium, watching with concern the pumping of an impaired left ventricle, then again out to stand over your sweating, grimacing patient in the throes of myocardial infarction, and finally hovering over the room, each concerned family member’s face registering like pieces of a puzzle.
Empathy is the ability to deftly understand the feelings and experiences of another person. This is a skill that any decent, caring individual has, but the profundity of your empathy is rooted in the fact that you can telescope through your patient’s experience, as above, in a matter of seconds. In medical school, we alternatively discuss complex pathophysiology and its psychosocial ramifications, seamlessly shifting gears between the two. We are thus bred to switch lenses at a moment’s notice, addressing every aspect of what our patients, and their families, are navigating.
Today, while rounding in the surgical intensive care unit, we discussed the differential diagnosis for impeded renal artery flow in a young patient who had been in a dirt bike accident: renal artery occlusion by a nearby hematoma, renal artery avulsion, and renal artery stenosis, among many others. But given the mechanism of our patient’s crash into a tree, along with the appearance of his abdominal CT scan, it became evident that he had most likely suffered a renal artery dissection. We then discussed the urgency with which the interventional radiology team had to stent the dissected artery lest the kidney be lost to global ischemic insult in a matter of hours. After reviewing his fluid status, kidney function, and addressing his litany of musculoskeletal injuries, we stepped back to consider the bigger picture of our patient’s accident. Does he understand the severity of his injuries? What is his support system like? How will all of this affect his recovery? Even in a fast-paced, intensive care setting, these conversations are crucial for proper patient care.
The very breadth of these considerations, buttressed by the expertise of the diverse members that comprise the healthcare team, was a result of our superpower: profound empathy within the framework of medical knowledge and understanding of the human experience. The effects of prolonged renal hypoxia, the patient’s respiratory status secondary to rib fractures, the ideal rate of fluid replacement, and the nature of the patient’s relationship with his family — all of these points were covered during rounds in succession like an orchestra weaving together movements of a symphony as one unit. This coordination would not have been possible without a deep understanding of the multitudinous factors contributing to the experience of our patient and a desire to address them.
Allow this moment of active reflection to remind you what you are capable of. Allow your humanism to arise from the fact that what you do every day necessarily requires you to consider your patients’ pathologies as well as their narratives. In fact, there is no care given that does not consider the depths of the person who is being treated. Your superpower affords you a constellation of perspectives that few possess. It’s up to you to recognize it.
Saurabh Sinha is a medical student and can be reached on Twitter @originalsinha.
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