Compartmentalization failed me, and I’m forever grateful

I’m humbled by the honor to practice medicine.  We have the opportunity to be frontline participants in an ever evolving cascade of events in the lives of others.  Our decisions, directions, and split second actions have the ability to unite families, sustain breath or literally a beating heart.  Although biased, I can’t think of many professions more fulfilling and honorable.  There are issues and concerns, but they pale in comparison to the fulfillment and gratitude I encounter on a daily basis.

As an emergency physician, I’m involved in many frontline encounters of life and death.  Our seemingly ritualistic care of the early morning cardiac arrest or untimely respiratory distress is almost clock worth with each emergency shift. Our mundane or norm taken out of context would seem absurd to the average lawyer, factory worker or investment broker.  How do we do this on a daily basis?  How do we hold the line, fighting death from disease and disaster, only to later sit down for dinner with our family and discuss little league soccer or the upcoming parent-teacher conference?   Our evolution from wide-eyed interns to compartmentalized providers is almost inevitable.  It’s our innate coping mechanism that allows us to practice in an often chaotic, emotionally draining environment at the top of our license and later disengage when the time clock is stamped.

As with most medical providers, we have our exception, the patient or encounter that manages to break through the evolutionary insulation that keeps us safe.  Sometimes it’s a personal connection, a subtle similarity, or almost divine encounter.  Maybe it’s the elderly patient in the resuscitation room, wearing the same fragrance of my lost grandmother or the pediatric trauma with the same Sponge Bob sock print that my son had on last night.   Whatever it may be, our worlds collide in an instant, and all defenses are lost.  You may remember the photo that was circulating of the physician on his knees crying in an ambulance bay.  This photo went viral, exposing a private moment after a traumatic event.  What was his encounter?  We may never know, but I suppose as physicians, deep down we all know.

Someone once told me that as providers, “We see death every day, until we really see it.”  Or another way to put it: “We see pain every day, until we really see it.”   It’s those personal connections, momentary cracks in the wall of compartmentalization that makes me a better doctor, father, and friend.  It’s those moments of clarity, the moment where the balcony view becomes front and center and all defenses are lost.  It’s inevitable, and I’m forever grateful of it.

Jeffrey McWilliams is an emergency physician who blogs at Advocates Of Excellence.

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