We always pay tribute to the amazing nurses out there and there is no doubt that it is deserved!
But what about our doctors?
Some are given unsolicited advice to keep an emotional distance in their job because it protects. But when they're told to stop feeling, it's telling them to stop caring, and caring is the most important thing they can do in medicine. Especially in these uncertain times with COVID.
One doctor once told me they've lost count of the many times they've had to look into the eyes of family members, taken a deep breath, then delivered the savage blow. It's a devastating side affect their job.
‘We did everything we could, but I’m so sorry, he/she didn’t make it.’
The reactions from that point on almost always involve tears. Sometimes there are cries of disbelief, hoping that what they heard wasn’t real. Some fall to the floor, others are stoic and fight tears. Grief may look different, but at its core, it is pain.
One rainy Sunday, despite gallant efforts, a very sick man finally succumbed to his sick heart. Health professionals kept him alive for five long days after a massive heart attack, with every machine known to medicine. Outside one of the private family rooms in the intensive care unit sat a trolley. A silver medical trolley was repurposed with tea, coffee and hospital biscuits. marking the room where a doctor is about to go and deliver the worst kind of news. The tea trolley in intensive care is synonymous with bad news.
'In his room, he lays peacefully and as cliched as it sounds, to the untrained eye, he looks peacefully asleep. The family sings and pray, promising to lead a life that he would be proud of them for. They thank him for his years as a husband and father and know that he is in a better place. The tears that were just pricking at my eyes then roll down my cheeks, silently because I feel like an impostor with my grief. Open tears would just intrude on their loss that I do not feel entitled to share in. I retreat to the mercifully empty theatre locker room and put my head in my hands and sob.'
A doctors pain at that moment is never that of a wife or a partner, a daughter or even a neighbour. However, the pain is still real and at times, and some wonder what a lifetime of seeing so much loss will do to them. Doctors have some of the highest rates of mental illness and suicidal thoughts in the community. Research has shown that losing a patient or experiencing a complication can have a devastating toll on a surgeon with guilt, anxiety, depression and using substances like alcohol too numb the pain. While it may seem that they carry on, with black humour, stoic realism or the odd tear, the loss of a patient has a lasting impact, at times haunting. Despite perceptions that doctors can be detached and uncaring it is really their ability to care that makes better surgeons.
If you were to add up the toll of a career of being exposed to challenging moments such as this, you may understand why.
Doctors and other health care workers often talk about this need to be detached as a protective mechanism. They carry on their days as if nothing had happened, or resort to dark humour. What if they have been getting that wrong for so many years? A study of oncologists showed that burnout is increased when these doctors have a negative attitude to displaying emotion. Perhaps by removing that barrier to feeling, they show more compassion to their patients and themselves. Sharing emotion after the death of a patient may help to battle burnout in doctors.
Medicine and humanity are inextricably linked and if you lose that gut-wrenching pain that comes with sharing bad news, then you will have lost your humanity. You cannot possibly truly care about the people you need to help if you don’t truly feel agony for them.
The next day presents new hope. A new chance for them to do what they could not for this man and so many others who slip away from them. At the end of that day, in the waiting room this time they might get to deliver much better news.
‘Everything went well, her heart is working well, and you’ll be able to see her soon.’
Despite the traumatic events of past days, these good days alleviate some of the hurt.
Whatever happens in the hospital, whether it be amoungst life-sustaining machines, under the lights of the operating theatre or in the emergency room, doctors are with you. They feel your pain and your joy in equal measure and both keep them toiling away. Healing on this occasion, helps not only you, but it helps doctors as well.