We huddled around in a circle. Some rubbing our necks, some touching our wrists, and some listening with tears streaming down our faces. It was a room of physicians and physicians-in-training, listening as one resident shared her story of watching her patient pass away when she ran a code for the first time. At the conclusion of her story, physicians and students approached the resident with hugs and advice.
“Look for hearts in the walls of hospitals when you feel at a loss. There are shapes in some of the wall colorings and finding the heart-shaped ones makes me feel better,” chirped a resident.
“I used to have my residents stop for a moment and note if someone had passed away with a moment of silence. We round on these patients daily, but sometimes we forget how to make them human when they are gone, ” said a physician.
“Before we lifted the cover off of my cadaver, we all took a moment together,” said a second-year medical student.
It was a communion of healers, not just communication between professionals — honest stories, not pre-fabricated facades.
I sat there, wide eyed. I was a first-year medical student, listening to the gift that was being given — physicians and residents revealing stories from their work lives and interactions with patients.
Physicians discussing patient stories is not new in classroom settings. Stories have long illustrated points, victories and spaces for improvement in a clinician’s ability to diagnose.
But this sharing of stories was special. These were not stories with outcomes to evaluate. Rather, they were personal. In a beautiful twist, through their own exploration of loss, pain and joy practicing their craft, these physicians were revealing the core of what makes them incredible clinicians — their vulnerable humanity.
Souls were being healed at the Spirituality in Medicine Leadership Training Conference, a yearly meeting led by the George Washington Institute for Spirituality and Health (GWISH), where a group of bright-hearted physicians from all over the United States, at all levels of professional development, gathered to care for themselves.
They spend two days together in a beautiful Sufi retreat center called the Abode, eating, talking and hearing presentations on keeping oneself whole and healthy in a reductionist system. It is hard to see the whole picture when we measure efficiency in quantitative outcomes that wipe clean the beautifully-garbled syntax of the life histories of individual patients. The conference was in its seventh year and had changed names, but still opened its doors as a place of refuge for health care practitioners and practitioners-in-training. This year, the theme was, “Life, Death, and Dying: Extending Spirituality from Physician to Patient.” In light of the tears, it was a perfect choice for what the physicians and students needed — to be compassionate for a moment and to recognize their own humanity when dealing with another’s suffering.
As I start second year now, I often find myself thinking about this conference. To see doctors as human is something we do not naturally do when we are training. Mistakes are not allowed. Death is something to defy.
Atul Gawande, in his novel-memoir “Being Mortal,” writes: “In the end, people don’t view their life as merely the average of all of its moments — which, after all, is mostly nothing much plus some sleep. For human beings, life is meaningful because it is a story. Measurements of people’s minute-by-minute levels of pleasure and pain miss this fundamental aspect of human existence.”
We as doctors often worry about the ending, as if everything in a patient’s and in our existences comes to that one moment. Perhaps it is the process of how to deal with this ending that could teach us more about the needs of the living? Too many times since starting medical school, I have heard statements that make death a villain, a mistake, and a failure. When talking about cancer causing organisms, a professor opened the lecture with, “In order to defeat death…” Furthermore, when physicians presented to us, they never once spoke of their personal thoughts as they held a dying hand or listened to a last breath. All we heard were case studies, successes, hard facts and “outcomes.” In fact, I began to wonder and honestly fear what “death” even looked like.
I was seated with experienced physicians of all levels of training, breaking ranks with our circle formations and “call-me-Bill” informalities, smiling, crying and listening to each one’s story on loss and triumph in their field. I was listening to “patient stories,” but it felt like I was being privy to physician ones as well — an invite to hear the experienced speak the hidden costs of “victory.” It was a gift.
Medical training too often emphasizes rules, lines and boundaries, but it is really in the spaces between the lines where colors blend into what is really beautiful: our celebration of all that makes us human. We should talk about the process of death and dying in medical training as much as we talk about birth and healing. We should not sway young minds so early to fight blindly before understanding that it is not about their victory at all, but instead about the patient and how they wish for their story to conclude. Maybe if we went to conferences to hear honest stories instead of crafted presentations, we would find the strength we are constantly searching for. To hear physicians share the moments of doubt they constantly face in their field made practicing medicine seem human. It is “practicing medicine,” after all.
The Spirituality in Medicine conference is for those who wish to revive their love for medicine, and reinforce their strength during the powerful years of medical training and practice. Such conference-communities can remind us of the second character in the patient’s story of death and dying — the physician — and how we keep living.