Ordinary and Exceptional

Fight For Your Life by *darkcalypso on deviantART

On my flight to Chicago to take my USMLE Step 2 CS exam, I sat next to a pre-med.  She saw me open my review book and asked, "Are you a doctor?"  To which my reply is, "I hope to be soon!"

At one point during our conversation while waiting for the plane to take off, she told me a story about how her mom had received a liver transplant.  She had been fine seeing other patients hooked up to lines and machines, but when it was her mom, it was far more difficult to see.  She remarked, "I think one of the hardest things for me when I get to med school is to not be too emotionally attached to certain situations."

To this I replied, "No, it's a good thing to hold on to your emotions."  Emotions are what make us human and is what draws some (hopefully many/most) of us to medicine.  It's surprisingly easy to detach oneself from a situation, that seeing exceptional situations over and over again make them ordinary - but it'll always remain exceptional for someone.  I believe the moment we lose that attachment, the moment we become cold and treat the patient as "just another patient" or a "bag of symptoms," that is the moment we lose our raison d'etre - if you will - for medicine.  It's not called "the art of medicine" for nothing, as the art represents the human side of care.

Once I arrived in Chicago, I was at a McDonald's getting coffee with my uncle when I eavesdropped on a nearby conversation.  A man sat down across from some friends by coincidence.  They asked him how his wife (I think) was doing.  He replied that she's probably alright, she probably didn't have a heart attack and was just released from the hospital, and that they did a big work-up involving an MRI.  The friends gave their sympathies.

A small part of me ran through that in a purely clinical and almost mechanical way.  But most of me stopped to consider how frightening it must've been for this person, their friends, and the patient herself.  This was an exceptional event.  But we in medicine see this kind of stuff often enough that it becomes normalized and even ordinary.  We sometimes become unphased by the gravity of the situation.  Is this necessarily bad?  No, as it helps us stay calm and collected under stressful situations.  But I don't think we should shrug off our emotions entirely, rather we need to acknowledge them openly.

In a moment of reflection and Zen, I think we in medicine should ask ourselves: are we more healer or are we more diagnostician (doubtless we should strive to be equal parts of both)?  Do we let exceptional events become ordinary?  Or do we, despite the ordinary-ness that exceptional events become for us, openly acknowledge that they are exceptional - perhaps the most exceptional - event for someone?