Doctor, heal thyself...

"Few doctors will admit this, certainly not young ones, but subconsciously, in entering the profession, we must believe that ministering to others will heal our woundedness. And it can. But it can also deepen the wound."
~ Cutting for Stone

I want to talk about this quote... And I will. But first I need to talk about where I've been for the past few weeks. Dublin is under a gloomy cloud right now. The bitterness of the weather is adding salt to the wounds left by the current economic climate (and an attempt to add salt to the streets, which is something they haven't quite figured out yet). We are in for a long, cold, dark, bleak winter here. And only time will tell how damaged Ireland will be in the long run. In the short-term, the people in charge have been making extremely short-sighted decisions that are going to prolong the pain. For example, the pay cuts to junior doctors, the current work environment of the hospitals are leading to (what at the moment sounds like half, but will most likely end up being) one third of my intern class leaving Ireland for greener pastures. Some will go to the UK, some to Oz and New Zealand, the North Americans are heading home... The best and brightest doctors, educated in Ireland, started training in Ireland, are going to leave. The fall out in the future health care received by ALL of this country will last years if not decades.

On the tail end of Thanksgiving, a bittersweet holiday for an ex-pat, the cold and snow only reminds me of a weak approximation of home. And the inability of people to cope with the snow and ice (the inability of the government to prepare for it again) has brought on American temper-tantrums as I've been rear-ended, knocked down on the sidewalks, hit with ice-balls, and invariably delayed at everything I've tried to do. I miss my snowboots. I miss my SUV. I miss shovels that work, ice scrapers for cars, rock salt at the grocery stores, snow plows that work, central heating, Caribou coffee... I've compensated for this feeling by cleaning and baking on alternate days. My fridge is full of food to re-heat, and my cupboards are full of cookies. And none of this can soothe the impending loneliness of being alone for Christmas. Not just away from home, but alone...

So where have I been? Have a cookie.

Now, in the middle of all of this disaster, I encountered an extremely painful moment at the hospital. Scrubbed in theatre, my hands in a patient's abdomen, their heart beating just under my fingertips as I retract, I hear the phrase, "They're dead."

Clinically speaking, logically speaking, that patient was going to die. There was nothing within our power to fix the damage we were looking at. But this terrified and aggressively angry voice inside of me wanted to scream. "THEY'RE NOT DEAD! THE HEART BEATING IN MY HAND!!" And in fairness to that voice, we closed up and the patient survived another 18 hours before passing away. With the exception of that phrase, the situation was treated with the utmost respect.

I still haven't sorted my feelings about that day. It's painful and I'm angry about it. I think I'm most upset at the callousness of that moment. There are decent ways to express and rude ways state the condition of a patient. Maybe it was rude. Maybe it was cold. It was certainly blunt and upsetting. And at the end of the day, there are a good number of my colleagues that communicate in a similar fashion. It's something I've been exposed to over and over again. And you know what... I don't think I ever want to be ok with it. It's the ongoing divide between growing a tough skin, because medicine is brutal, and maintaining humanity and dignity in spite of the things you see. So... Am I healing? Or am I tearing open old scars?