My eyes glare across the table. I can feel his shoulders hunch forward as he subconsciously recoils in preparation for my response. The room becomes thick. Nurses, social workers, a chaplain. Everyone waiting for the doctor.
Not just the doctor, but me. Sixteen years out of residency. Battle-scarred and warn by PTSD. The images from residency still so clear. A gasp, a gurgle, flat line. Wailing family members, angry nurses, and an uncompromising chief.
They died so much more easily back then. The young, the old, the unwanted, and the uncared for. The academic medical center with its social mission. The Veterans Administration, untethered and unloved.
Practice. We practiced for lack of a better word. We stumbled into situations too big and too great for our burgeoning grip on competence. We learned as we taught. We taught as we mastered. We mastered in the single digits.
Emerging from training was like a breath of air. But not clean air. Smog. The same thickness. Life’s murkiness banished to that protected oasis long hidden in the recesses. Just out of reach.
Schedules fill. Patients to squeeze in. The morass of physical and emotional trauma. Ducking from the base insults hurled at our backs, and delivering the same into the next examining room when patience grows thin.
Dragging such toxicity home on the belabored backs of our families. Of our children. The raspy voice declares death over the phone with cold and surgical certainty while the kids watch cartoons on a Sunday morning. Clear-eyed retribution turns to tears when the storyline on the big screen goes awry.
That which I miss most
In this beloved room full of colleagues battling to make the last gasps of life bearable. Is the softness. The weakness of heart and the quietness of spirit. The empathy that lifted those around me instead of made them cower.
The absence of fear, and anger, and helplessness.
Not of battling life or death. Not of winning or losing. But of learning to feel unhindered. To feel again.
I defang my claws. Drop my shoulders and consciously restrain the edge in my voice.
And I do my best to fake it.
Jordan Grumet is an internal medicine physician who blogs at In My Humble Opinion. Watch his talk at dotMED 2013, Caring 2.0: Social Media and the Rise Of The Empathic Physician. He is the author of Five Moments: Short Works of Fiction and I Am Your Doctor: and This Is My Humble Opinion.
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