Helping doctors be happy, healthy and whole
What seemed like a typical day in the Emergency Department turned into a life-changing moment.
I was working my way through the list of patients, ticking them off, one by one, in order of emergency. In the ED we have “screen, treat, and dispo”—we determine what a patient needs, stabilize and treat them, determining whether or not they are sick enough to be admitted to the hospital. We try to get through as many people as possible because the next patient in the waiting room could be the sickest one there, and might need more immediate attention.
When I saw that my next patient’s complaint was “anxiety,” I felt myself disregard him before I even arrived in the room. I thought, “What can I do for him here in the ER? I hope he’s not another drug-seeker.” It wasn’t that I’d lost compassion for patients with anxiety and drug addiction. It was just that I saw so many of them in the course of a day that it was hard not to be dismissive at times.
Michael was sitting on the edge of the bed. He was a young man of thirty-five, well-dressed in a crisp shirt and neatly-ironed slacks. He tried to give me a friendly smile, but his face was stiff from pain.
He told me that he was a nurse in the hospital, but was unable to work or support his family because his anxiety was so bad. He knew from his training that there was probably nothing I could do for him, but he was just so desperate. He didn’t know where else to turn.
I saw it right there: the pain in his eyes. Something about his desperation touched me so deeply that it jolted me out of my Emergency Medicine mode and I saw a fellow human being, suffering. The compassion of truly witnessing someone else’s pain that had been suppressed for so many years in order to survive as a Western physician poured out of me. In that moment, I realized it was more important to bear full witness to this man’s pain than to come up with any kind of solution. I sat with him for half an hour (a huge amount of time to spend with someone who is not emergently sick in the ED), and listened to him as he spoke about his life, his kids, and how his marriage was starting to break down due to his anxiety—I sat and listened without the need to “fix” anything.
When I went home that night I felt shell-shocked. The whole way that I had been taught to practice medicine did not fit that experience. We are taught that it is necessary to wall off the suffering of others in order to practice. Yet my deep, innate sense—everything I was feeling—was telling me the opposite. I began to question all of the traditional teachings that seemed to be standing in the way of being the whole healer I had set out to be. I realized that so much of what I truly considered healing came less from following formulas and protocols, and more from being in touch with the human connection that deeply embraces both joy and suffering. I understood for the first time that unless we can fully feel with someone, we cannot be authentically compassionate. On that cold November night I had what can only be described as “an awakening of the soul,” where I realized not only how essential compassion was to my practice but also that we cannot fully be loving and present with another human being if we are not fully loving and present with ourselves.
It was a profound experience that touched not only my career, but every waking moment of my life, every relationship, and every interaction I had from then on. I went from mechanically and efficiently practicing medicine (and life), to being deeply present with everything and everyone I connected with, myself included. It was the beginning of the process of knocking down the outer walls to reveal what was underneath.
The next moment of awakening came when I was washing someone’s feet.
Following these first realizations, I made the decision to take two months out of my schedule and go to the mountains of Nepal to practice medicine with those who do not have access to Western medicine. Besides making an authentic contribution, I also wanted to get a new perspective on medicine, beyond my formal Western training. On my first trip, I set off up the mountain with nine other doctors, two nurses, an acupuncturist and other healing professionals. I had no idea what to expect. But it was actually in the simplest moment that I had my most profound experience.
I was kneeling in the dirt in front of the blue tent door flap fluttering in the mountain breeze.
An elderly village woman’s feet were in my bare hands. I dipped her dry and calloused feet into a basin of warm, soapy water, held them in one hand and picked up a nail brush with my other hand to begin scrubbing at the dirt in preparation for her acupuncture session. Her feet jerked back as I started with my brush. I was startled out of my concentration, having forgotten for a second that those feet belonged to someone. I looked up at her, sitting on a wooden school bench in the middle of the freshly harvested barley field that was serving as our medical camp. Her wizened face was smiling shyly, framed by bright mountain sun and the vast Himalayas behind her.
We looked at each other, both seeing the absurdity and joy in that moment, and although we didn’t speak the same language, we had a moment of connection that led to us both laughing hysterically. It was quite some time before we could stop.
The examples above were just two of the many experiences I had in my awakening as a whole healer and medical practitioner.
What they represent to me is the joy of connection filling my heart. I went from being an ER doctor, efficiently and mechanically carrying out medicine, to being able to bring my humanity into my practice. I came to believe that in order to work authentically, we have to acknowledge the full spectrum of human emotion. We need to be able to feel the suffering of another human being in order to fully share their joy.
These understandings led to the question, “How do we break down the walls we have made, particularly the ones that were built during a medical education based on the erroneous belief that connection and emotions are the enemies of professionalism?” It’s a question that I continue to ask in my own practice, and one I ask on a daily basis with the many doctors and medical professionals that I work with privately. There are similar questions, such as
These are not just questions that make our patients’ experience more pleasurable. They are questions at the core of life’s purpose. Because what I have come to realize is that: living and operating from a mechanical place where we go through the motions with our patients is what breaks us down in the end. In order to be fully present, alive, and engaged in what we do, we need to have that human capacity of acknowledging both suffering and joy simultaneously.