The Value of Empathy in Medicine: An Intern's perspective.



Having survived my very first quarter of internship, I decided to share some gained perspectives. I have never taken for granted for once the rare opportunity for a foreign medical graduate like myself to be able to take my residency training here in the United States of America.
Even though this is like my third internship literally speaking, across three different continents, this is totally different. I do not know if the fact that the first time I did intern year, I was a young fresh graduate from a medical school who had just been officially "unleashed to the unsuspecting society" in the voice of one of my professors back in Nigeria ,who had this practical joke of a statement about interns. I approached and embraced life as a real doctor with great gusto. I aced intern year without stress or tears. I was by myself.

The second time I did intern year, I was back in England. I have always been a soul passionate about medicine. Such that when the winds of life blew me to the land of the Queen, while husband was following his dreams of pursuing a Masters at the prestigious Oxford University, I took all the board exams and did my intern year, again. That statement I summarized into a single sentence involved a lot of sweat, midnight candles, and a lot of pound-sterling. This time I obviously had a husband.

The third time and definitely the last time(I had a conversation with myself, this is it!) I found myself doing an internship at this really wonderful program that chance alone cannot explain how I landed here. There has to be an alternative explanation from the universe for how this happened. Call it sheer stroke of luck, call it a miracle, you definitely would not be too far off from the truth. This time, I am not by myself. Now I have a husband, a son and a daughter.

Life has handed me a fair share of the bargain. I have been through pain, overcome insurmountable hardship, trudged through loads of adversity, yet nothing I have been through prepared my for this - Residency in "The land of the free and the home of the brave". Not even my novelty experience of living in the City of the Dreaming Spires. You would assume that there would be a magical innoculation of some sort having lived and trodded the same soil as Stephen Hawkings did. Unfortunately, life does not seem to work that way. How disappointing.

However, it has not been all doom and gloom. The sacred occasion to handle and care for human lives, the smiles on the faces of patients relieved of their initial sufferings, the intense gratitude from family members, whose loved one's life, you saved. The feeling of accomplishment that you truly made a difference in the world. These are worth more than gold.
 In those  first few months of residency, I have been so close to tears, literally on the edge of wailing but summoning all my will-power not to disgrace myself, my family and the entire medical profession because doctors are not supposed to cry. Like we are some super-humans with some encrypted genes that make us immune to physically expressing our emotions. We are supposed to maintain that outward stoic stance of the formidably, unperturbed personality. It is anathema to express your emotions, so we bottle things up till perhaps many exceed the elastic limit beyond which they cannot handle it all anymore.
One thing I can say is that I still have my empathy intact. The fact that I can still feel something. This is still a good sign. It has to be. Many do not simply feel anything anymore. It is almost like their souls are fibrosed! When a tissue is exposed to so much injury, it tries to heal itself, it goes through a process which involves inflammation trying to default to previous setting and eventually fibrosis occurs. Many healthcare professionals are "scarred" from the many "trauma" they face daily.

I was very close to tears as I watched the family of that man helplessly sat transfixed as my team back in the ICU ruined their day by telling them their father and husband was not going to make it. True to the prediction, he died that day.
I will never forget the forlorn look on the face of that mother who told me her young daughter had a DNR(Do Not Resuscitate order) in place. As I took the history about her daughter from her, my mouth quivered and I literally choked back tears as I struggled to wrap my head around how she seemed so settled about the inevitable.
Another instance was having to "break bad news" to a family. For any intern or any doctor at all, this is always a tough one because what you are about to say will forever alter a family and your face shall always be imprinted on their memory as the "harbinger of doom" of some sort.
It is a tough job.

The question is How do we deal with this day in, day out? Especially, coupled with the events, twist and turns of our own personal lives? How is any medical professional okay?
How do we maintain our passion for the profession, our unflinching love for medicine, commitment to save human lives and empathy in the face this enormous avalanche of emotional overload?
How do healthcare professionals handle the stress life throws their way every single day?
Physician burn out is a real thing.

Many times, I have felt like stopping many of my colleagues to ask them if they truly love this life, this job.Of course, I stiffle the thought and bury it deep down in the abyss of my soul. Simply because many times I see pain and regret in people's eyes. I see frustration written all over many faces. I see a lot of people who "show up to the job". For the love of mike, there are bills to be paid! Totally understandable.
I do not even want to digress into the reasons many chose the medical profession. Obviously, if you chose it simply because of money, you are definitely wrong.

I was taken aback when one of my colleagues actually asked me genuinely if I was doing ok. The person had asked specifically, "How are you feeling?" Of course I was not doing "Okay". It's residency! How could I be? I felt chronically sleep deprived, with two little ones- both under five to care for on my own(hubby travels a lot for work)  and close to mental exhaustion because I am on a rather busy stretch on the rota. However, the next thing the person said blew me off. Totally unexpected. "I will be praying for extra strength for you tonight" was the magical phrase uttered by this lovely person.  I was shocked because, sincerely no one at work has ever said that to me.
Imagine a medical work environment where we all look out for each other or even go the extra mile to even pray for extra strength for one another. Imagine a perfect work- place totally rid of its unhealthy hierarchial rivalry or the typical "mind your business attitude" in the setting of calculated nonchalance. When people, would take a second to genuinely inquire after one another and lift each other up in words and in deeds. Perhaps, we might be able to cushion a "fall" that would have otherwise been fatal or prevent anyone from 'arresting' in their journey of  life. Then perhaps we could save more people, we could save more of our very own.



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