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I have a confession to make: I sometimes look forward to my trips to the bathroom at work. Being a busy pediatrician, it can be the only alone time I get to myself; and on occasion you just need a quiet place where babies aren’t crying and phones aren’t ringing. The other day as I was leaving the bathroom and returning to the bustling clinic, I did something strange. I knocked on the door before I exited the bathroom. It has become so much a part of my routine to knock on doors as I enter rooms that my brain apparently now knocks on doors as a reflex of sort. Luckily, no one saw me do this, and I left the bathroom pretending to have done nothing abnormal.

While the aforementioned story is obviously light-hearted, much of healthcare is not. Practicing medicine is rigorous; it consumes the person that you are in many ways. What is often overlooked in medicine is the emotional heft of dealing with hardship that the doctor himself or herself experiences. A doctor, nurse, or anyone involved in the healthcare of people is often at the eye of the proverbial storm.

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Unfortunately there are many more of these memories that haunt me. My journey in pediatrics has been lit by the laughter of children, but the moments where they cry or suffer bear a turbulent burden on my soul. Nobody really teaches a physician how to deal with the emotional consequences of being involved in such poignant moments. I know that personally my emotional gas tank only holds so much fuel. There are days after work where I seem like a zombie to my friends and family. Occasionally in the midst of my day, I find myself being warm and friendly with my patients and their families, but rather cold and removed in my relations with the office staff.

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I remember a blistery winter day while I was in medical school in Ohio. The snow covered the streets and I felt lucky to be on my obstetrics rotation in the warmth of the hospital, where I wasn’t paying the heating bill. Suddenly the senior resident said we had to run down to the ER for an emergency. The moments that followed have never left my memory. A pregnant mother had gotten in an automobile accident and her car flipped several times. She was rushed to the ER and in front of my anxious eyes and racing heart, the medical team tried to resuscitate her and her baby. Neither of them made it past that ill-fated day. An hour later I was there to witness the moment that the father of the baby learned of the tragic news in the trauma bay. I will never forget the sound of his scream as his body went limp and fell to the hospital floor.

Medicine is a grind on the heart. We need more resources available to physicians and healthcare employees to ensure that the ones giving treatment are being treated themselves. It is also vital to create a culture where seeking help in dealing with the emotional toll of medicine is encouraged, and not looked down upon. Many doctors (myself included) are too stubborn to seek out such therapy, because we are trained to see ourselves in the provider role, and don’t quite understand how to be patients.I certainly don’t mean to treat anyone poorly in my personal life. However, trying to calm everyone’s worries is more draining than I would have imagined. Some days I have 40-50 different patient encounters of various kinds, and each of these requires me to be emotionally available. In the process of training to become a physician we are rigorously instructed to have the tools to weather the storm (i.e. diagnose and treat conditions). Sadly, we are poorly taught on how to keep ourselves afloat after the storm has passed.

I don’t want to suggest that I’ve gained some kind of privileged understanding of all the moments I have encountered as a doctor. In fact, I don’t know if I ever will fully comprehend the seemingly random events that make up our lives. I do know however that I am not ashamed to admit that these encounters affect me and shape the person I am. They lead me to laugh at myself when I knock on a bathroom door, and to shed a tear when tragedy unfolds. Hopefully, they will also lead me to a better understanding of myself and everyone else who touches my life in one way or another.

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There’s a lot I’ve not forgotten
I let go of other things
If I tried they’d probably be

Hard to find
The National “Hard to Find”

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