They say in The House of God, “at a cardiac arrest, the first procedure is to check your own pulse.” A popular idiom for emergency room physicians, I believe this proverb’s main intent is to remain calm under pressure. It may also require us as physicians to detach ourselves from our patients, lest we let our emotions impair our judgment.
During our hematology class, we took a break from the science of cancers to hear from patients who have (successfully!) gone through various stages of blood cancer. It was powerful and moving. It is courses like these that remind me why medicine is such a powerful field. We were asked to reflect on the class, so here are my thoughts:
“I was reminded of the phrase. But this time, its meaning shifted. Instead of reflecting a need to stay calm in the most pressing of situations, it took on a different, almost paradoxical, translation. Yesterday, ‘check your own pulse’ become a commitment to remind oneself that you yourself are a human first, fully fallible and heavily affected by emotions, and that these are valuable (not impeding) in treating our patients.
If you think about it, the pulse, in essence, is an echo of the heart. It carries the instructions of the heart, obeying its rate and rhythm (barring a differential of arteritis or atherosclerosis of course). Your pulse beats almost musically, with a cadence that supplies and fulfills the person.
We heard from the patient panel that the finest physicians were those who essentially treated the patients as people. They asked about their home life, their job, their pets, their hopes and fears for treatment. They made no promises, yet they stopped at nothing to find answers to their patients’ needs. These physicians are those who do not separate the humanity from the medicine. In fact, they embrace it.
We put on our white coat, and often times, it’s easy to dehumanize. Whether it’s a defense mechanism, a fear of making the wrong decision, or a safety blanket, it’s easy to lose our own humanity, let alone lose sight of the patient’s humanity. And patients do notice. For me to stay present, it’s imperative that I bring in my full self, not just the physician persona. It’s a reminder to the patients that there is medicine and there is an art to healing. They also need both to get through the healing process. So I’ll continue to check my pulse every day for each patient.”
I hope that everyone gets the chance to take a chance to step back, listen and remind themselves why they continue to pursue this profession.