Why am I here? It’s already a half hour past the end of my 12-hour hospitalist shift, and I’m hustling to finish admitting a new patient from the ER. Once I finish, I still need to see patients at another facility before I finally wrap-up for the night and head home. Staying late is a professional courtesy for tonight’s nocturnist nurse practitioner. Nocturnist mid-level practitioners are a unique breed of medical rock star, not only because they choose to work at night, but also because they recognize when they need to call the on-call doctor and when they don’t. So even though I’m on call tonight, I know that I won’t hear from her unless there is a critical need. The least I can do is finish this admission.
Why am I here? I’ve been on call for new admissions today, and it’s been a madhouse of the season’s pneumonia, influenza, and the usual parade of cardiac complaints. The other doctor working with me this week took a few new consultations from the neurosurgeon and orthopedist to ease my load. I text him a quick thank you, complete with dorky emoticons, and ask him if his wife has found them a new house yet. He goes home a little earlier than me today, to rest up for his on-call day tomorrow.
Why am I here? I pause outside the door of my patient’s hospital room, hand resting on the door handle, waiting to deliver life-altering news. I am keenly aware that I am experiencing the last moment of life as he knows it. The pause seems impossibly infinite, and the burden of his illness tries to burst from my chest. He smiles cheerily at me as I enter, but his wife can see the truth immediately when she meets my eyes.
Why am I here? Driving home, I’ve reached a dark stretch of highway between towns, where your cell service drops and you fly past fields of sorghum and sleeping 18-wheelers. My mind returns to contemplating why I continue to practice this messy art of medicine.
I am here because of connection.
Business visionary Seth Godin says, “connection is the scare resource.” In the fast-paced world of hospital medicine, connection can, indeed, feel scarce — leaving us isolated, drained and unhealthy. I am fortunate that my hospitalist team is connected: connected to our patients and to one another. We have worked harder, longer or later because the patient needed it. We have traded shifts or worked more in order to make each other’s lives better. We have had babies and had cancer. We have traveled to tropical islands for vacation, and traveled across the globe to bury our parents. We have gotten married, and gotten invasive procedures. We have worked near our breaking point, while knowing that we will not break. We are held together, holding on to each other.
We choose to be here because of this connection. We realize that we cannot practice good medicine if we aren’t caring for each other, and for our patients, through authentic connection.
How can we initiate this connection? How can we maintain this connection?
Connection is nurtured and sustained when we open ourselves more, share more, engage more and listen more. As counterintuitive as it sounds, if we extend more, not less, of our energy to patients and peers, then connection is fostered and energy is generated not depleted. Connection allows us to bring more of ourselves to the patient, to the encounter, to our colleagues and to the moment. Connection generates synergy and allows us to create something larger than ourselves, something truly great.
Why am I here? I am here for connection.
Beverly A. Zavaleta is a hospitalist.
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