Below are moments from my intern year of general surgery residency. They represent moments that occurred over three years ago, which I took home to my journal to process and work through. Back then, the moments left me speechless. And today, re-visiting them, the moments clearly demonstrate the fragility of the human spirit. A silently sobbing 7-year-old the day after surgical repair of his broken femur. His face contorted. His pain was nearly palpable. Tear ducts dry. Dehydrated? Or, merely no more tears to cry? A paraplegic who is now a double amputee. He had post-surgery remorse and asked why we cut his legs. The fact that they were previously maggot-infested, infected to the bone, and a threat to his life was not enough of a reason in his mind to spare them. A daughter who sat on the hallway floor, head in her hands, white-knuckle gripping the phone, her lifeline. Tears streamed down her face, as she realized her father was a shell without a functioning brain. A chronic pain patient, a frequent flyer, addicted to the IV pain medications and the IV Benadryl, but more importantly, addicted to the people who entered her room daily and cared to ask – how are you? How is your pain? A five year old who’s been the recipient of more physical, sexual, and emotional abuse than any one person should experience in a lifetime, who still gets giddy when given silly puddy. He even smiles. While doctoring, we are bombarded with the limits, the pitfalls, and the pains of humanity. We are given minimal time to digest, as the next patient awaits. We stoically move from room to room, witnessing the direct impact of disease and its treatment on lives and on families. We offer boxes of tissues as if a Kleenex wipe will suffice. As an intern, I journaled, “You see, I’m only three months in, and I’ve seen some things. I wonder what a lifetime of such direct exposure to pain and suffering does to one’s spirit. I realize doctoring is hard.” Today, as a fourth-year general surgery resident, my rebuttal is complex. Yes, the pain of doctoring is hard, but the triumphs of competently managing and impacting your patients’ clinical courses are unparalleled. It’s easy to discuss and address the latter and the fuzzy feelings associated. However, what’s more important is to acknowledge the pain: The pain we witness; the pain of training; the true, often unspoken, pain of doctoring. As a profession and on an individual level, we need to learn and focus on processing the pain in a healthy way. Processing does not mean self-medicating with alcohol or drugs or other exploits, which many succumb to. Instead, it means demanding both time and safe spaces to unpack and work through the difficult moments. This may mean discussing difficult cases with mentors and colleagues, seeking therapy, or unwinding with your favorite reflective activity. It may occur at work or on your own time, but you must reset. You must take and be given the time to separate from the profession’s demands and process all that you go through because you cannot continue to compartmentalize the pain, angst, and trauma. It is not sustainable. Source
