Despite travelling by plane a LOT, it wasn’t until my second year as an attending that I got the frantic, “Is there a doctor on board?!” call. I was napping fitfully on an early morning flight but was jolted awake by those words and to my surprise had jumped across my row mate’s lap before I knew where I was going. It wasn’t until a full 5? 7? minutes later that someone said, “so you are a doctor.” It was a statement, not a question; I suppose it was obvious as I ran toward the actively seizing person? Ultimately, I did very little to help him — as the seizure terminated spontaneously — but I must admit it was one of the most satisfying patient encounters I have had.
That morning, I felt the way I had imagined I would feel as a doctor every day. You see, gratitude is a powerful thing and for many of us medicine was a calling much more than it was a career choice. Believe me, with $500,000 of medical school debt and a fellow’s salary, I am not getting rich practicing medicine. And many days I feel myself becoming poorer in the resources that brought me here: empathy, compassion, and grace.
In my short five years as a physician, I have been repeatedly surprised at how powerful an act of kindness can be. We frequently talk about being kind and the relationship this builds with patients and their families, but the kindness I have recently become infatuated with is that for physicians. Inherently, we are human and not only does a kind attitude make us feel good, it actually makes us perform better!
These days I work in a busy tertiary care referral hospital in the Northeast. Particularly during this past hellish flu season, patients routinely waited hours to see me and frequently had been referred by their doctor or providers at another facility. Granted, I always start these encounters with appreciation for their patience, but I must admit that patients’ attitude toward me provides a fair amount of the flavor of our (short-lived) relationship. And their rare words of appreciation literally make my day. We all understand and support advocating for a family member or oneself, but it’s much harder to do our jobs when there is a tone of antagonism. I suspect we all do our best to stay out of rooms that do not feel safe, particularly when we are tired, hungry, or simply running low on resilience; this is an even greater challenge for our residents, who are routinely working 80+ hours per week. Unfortunately that can be dangerous in an acute care setting in which the landscape is rapidly shifting, and small details may be paramount. We are all well aware of the staggeringly high rates of burnout in EM and this added element of emotional labor is surely a contributing factor.
After rushing to the back of the plane to witness the last 15 seconds of a focal seizure, assessing ABCs, and reassuring the patient (repeatedly during his post-ictal period) and his family, both they and the crew were immensely appreciative. I was surprised because I had done nothing at all, aside from awkwardly taking his blood pressure at the captain’s request. Was it because I was “off duty” and therefore volunteering? That is hard for me to imagine given that the vast majority of physicians I know see doctoring as a fundamental part of our identities and something that we never turn off. What I do know is that I felt so gratified that I was able to be there in their moment of crisis, that I had the knowledge and skills to know what to do if things got worse, and that it felt really good to be able to provide this service. I felt like a superhero and I would encourage us all to try offering a healthy dose of kindness on our next shift and see where our teams end up.
“Treat everyone with kindness, even those who are rude to you, not because they are nice, but because you are.” – Unknown