In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope

It is entirely possible to feel someone’s pain, acknowledge their suffering, hold it in our hands and support them with our presence without depleting ourselves, without clouding our judgment. But only if we are honest about our own feelings.

The traits we revile in others are often the ones that remind us most of our worst selves. And we react most strongly to the faults and flaws we see in others that we are most ashamed of in ourselves.

We cannot define success as beating death because death cannot be beaten. The undeniable fact of death remains, imposing and impending regardless of our temporary victories. How we care for each other during life is the true restoration—the definition of agency. That is the win, the success we must look for and mark and define ourselves by. Our ability to be present with each other through our suffering is what we are meant to do. It is what feeds us when the darkness inevitably looms. We cannot avoid the darkness, just as we cannot evade suffering. Loving each other through the darkness is the thing to look for and to mark. It’s there, in the shadows, where we find meaning and purpose.

It seemed a terrible blind spot that we did not discuss the toll those errors exacted on us. Medicine is not oriented to recognize trauma in its own. We do not debrief our team or even ourselves after a code. We do not pause and assess the emotional well-being of our colleagues after they lose a patient, the way we pause to assess the root cause of errors. We were trained to leave the thin veneer covering our colleagues’ emotions undisturbed. We have utterly no idea what to do with shame. We have built no confessionals.

Oppression, by its nature, breeds the power necessary to mount a resistance and to overthrow itself

The trouble with not having a safe space within medicine is that for those outside of medicine, our stories are almost too much to bear.

It’s just that I want you to know, it never gets any easier, you know? But it will be fine. One way or another, it will be fine.

Learning to listen had made me able to hear.

Who we are when everything is stripped away, in our barest moments, is something we don’t routinely examine. When a horrific loss uproots us, we leave pieces of ourselves behind in the soil, the structure on which we built our identity reduced to nothing more than an absent appendage, left behind to rot.

I identified with the life cycle of tulips and other perennials. Their hopeful rebirth each year, enabled by a graceful return to the ground. Rotting as a means to transform.

We subconsciously construct a narrative in which the doctor-patient relationship is somehow antagonistic.

We aren’t trained to see our patients. We are trained to see pathology.

Hope was an orientation, a way of being in the face of a reality that was not of their choosing. Hope was a destination they had arrived at when the situation had been wrestled to the ground and stared at, bravely.

you have a really hard job'... There was no judgement and no attribution of blame, only acceptance. It was such a simple validation, and yet for us, in those moments of risk and exposure, it was what we needed.

It is possible to be both broken and incredibly strong. We can be wounded and in that space find more cohesion and wholeness than we knew possible. But only if we are willing to acknowledge and confront the cracks.

Emotion demands to be acknowledged and appeased before it will disengage its controlling grip on the higher centers of cognition.

My heart remained in the patient realm. I felt my patients’ fear, I felt the weight of fluid heaviness in their lungs when I studied their chest X-rays, I knew their pain. And far from being the distraction I’d been cautioned against, it felt very right to feel with them.

Even as I approached the emergency room that first night, my thoughts were the measured, structured thoughts of a physician. I was unable to relate to myself as a patient. Presented with the problem of pain, I responded by listing differential diagnoses and prognosticating for myself. When I found myself dizzy and unable to stand in OB triage, the physician in me perversely enjoyed experiencing shock firsthand. The intensity of my focus on medicine was such that I felt fortunate to have the learning opportunity, to personally engage with the pathophysiology I had studied for so long. I knew I was dying, and I was still awestruck by the science of my decline.

Difficult” was a shorthand for “The patient is not going along with the plan. I have a good solid plan, and they aren’t on board.” I wondered why we ever presumed that our plan should be the barometer by which we measure compliance. Why our agenda was preformulated and not collaborative. Why we insisted on creating a dynamic in which one person wins and the other loses.

We cannot change that which is true and sad. But we can acknowledge it. We can humbly witness suffering and offer support.

They are doing their best to believe that they are worthy of the compassion and humility of a stranger. A humility that dictates that while we cannot possibly understand every patient’s story perfectly, we can trust them to tell it, without imbuing it with our own biases. And when they tell their story, we can receive it, and bear witness to it. And in return for their willingness, however tenuous, to put their faith in us, we can do our best.

I had subscribed to the paradigm of medicine set forth by my mentors, one that advised me to cultivate space, to be sparing of myself. I was taught that connection begets loss, which in turn begets disillusionment and burnout.

When we are sick, we are humbled by our dependency on others, the loss of control, the uncertainty of the ending. This change opens channels for communication we are hardwired not to tune into during the monotonous routines and spaces of normal life. Recognizing those open channels and fostering connection in full view of the knowledge is what heals. Making the choice to be present for someone else’s suffering requires a kind of anticipatory resolve. Because it does get hard, sometimes even unbearably so. The choice to be present means deciding at the outset that you will be there for the duration.

While the rooms our patients inhabited were the sites of shared trauma, they could not assume the connotation of a consecrated space; they had to be reused.

There was a range of distress expressed that went from compassion fatigue to addiction to full-fledged burnout

I am not sure I understood what was motivating my behavior. I know I didn’t recognize that an emotion was driving my compulsive research. I would not have characterized myself as particularly anxious. In fact, I would have labeled it something else entirely if asked. I was advocating for myself. I was educating myself. I was taking an active role in my care. In retrospect, I can recognize that I was also completely terrified and, not knowing how to quiet my fear, took the only option I thought available to me: to attempt to bludgeon the feeling into submission with data. The problem with responding to emotion with data is that emotion doesn’t recognize it. Ironically, I was making the same mistake with myself that physicians make with their patients. I was not naming or tending to my own emotion.

Hope was not, as I had believed, an unrealistic, unfettered optimistic emotion. Hope was an orientation, a way of being in the face of a reality that was not of their choosing.

The emotions of patients are encoded in their behavior. It’s an easy task to recognize a crying person as sad. But a compulsively attentive patient, documenting every lab result and asking well-formulated questions about antibiotic choices, is less easy to decode as anxious. I myself didn’t recognize my own anxiety at the time. I believed I was appropriately adapted to my environment. An environment that required intense vigilance and anticipation of some impending cataclysm. The casual complacency I observed in others struck me as horribly naïve. Every solicitation to “just rest” filled me with contempt. I knew what would happen if I left the watchtower untended. I would die. I believed it was entirely up to me to ensure my own safety.

No matter what happens to a person, he or she will always be who they were meant to be.