The raw beating heart of Emergency Medicine

I was really honored to be able to return to my residency alma mater, SUNY Downstate/Kings County Emergency Medicine, this past Wednesday to go a 2-hour wellness talk.  Everyone was so enthusiastic and engaged!  To be honest, I was nervous going back to give this talk.  I remember when I was resident I didn’t give a damn about wellness.  I figured I could just power through residency and all will be OK.  In fact, I went so far as to feel that any discussion of anything soft and non-clinical was a sign of weakness.  Oh, how life throws curveballs!  And now I’m standing in front of 100 residents and faculty, talking about the hidden emotional life of physicians and guiding meditations.

Two days before the lecture, I had the whole thing planned and written but I wasn’t completely happy with it.  I realized that the brain was there with all the interesting tidbits about meditation and wellness, but the heart was missing.  There is so much talk about wellness in terms of stress reduction, how to focus better, how to work better, sleep better, eat better.  All of this is important but we tend to shy away from the raw, beating heart of it all.

After some hyperventilating and nervous pacing, I decided to change my lecture to start with this:

This is a viral photo of an Emergency Medicine physician in Southern California immediately after losing a 19 year old patient last year.  Every time I look at this photo, I get a pit my stomach and a familiar sting in my eyes.  Every emergency physician knows this, it’s as much part of our job as suturing or thoracotomy but it’s not something we talk about.

In the Emergency Department, we have a unique vantage point of humanity.  It’s raw.  We see deaths, births, terminal diagnoses and everything in between.  

We’ve been taught to hold it all in.  We are afraid that our humanity would somehow interfere with our clinical persona.  We are afraid that if we get too in touch with that part of ourselves that grieves, loves, connects, rages, we will no longer be able to function as impartial agents of medicine.  But the truth is, we are human.  Denying our humanity is partially what burns us out and causes secondary traumatic stress from witnessing life in it’s most distressing forms.  When we push away death and suffering, we also push away full-spectrum living and beauty.  Life in the Emergency Department can be tragic.  But life itself is tragically beautiful.  We’ve spent too long futilely pulling away from our humanity to deal with the realities of being a physician.  I’m passionate about being part of the new paradigm of truly integrated physicians.  Physicians who invest deeply in ourselves, and with some skills and practices, are able to lean courageously into our humanity to become better physicians.  

Reach out if you're interested in exploring this exciting new paradigm with me!