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Thursday, March 30, 2023

Opinion: Young doctors struggle to navigate human suffering

I am a resident physician, a brand new doctor. I am just starting my residency training. The process of becoming a doctor is long and tedious and involves tremendous work and firm commitment. We complete undergraduate education, four years of medical school, and three to five years of residency. However, the hardest part isn’t academic or professional stamina – but developing a personal and professional identity when you see your fellow man’s suffering.

We as people collect experiences through our lives that shape us and our narrative. Many of these stories are delightful. Some are mundane and only important to the individual. And unfortunately, many are unhappy, even tragic. By the time people are in their sixth, seventh or eighth decade on this earth, they have accumulated a lot of experience. These experiences give them a certain perspective – this is called wisdom or maturity – that allows them to refer to novel and stressful events in a way that young people simply cannot. They say things like: “After all these years, nothing surprises me,” or “I guess life just goes like this,” or “Time is fleeting; you have to make the most of it.” ” These statements reflect an advanced worldview that young adults may not fully understand.

As a medical trainee, you as a fairly young adult are suddenly exposed to an enormous amount of human suffering. I started medical school at the age of 23. Now I am 27 years old. Our systems are filled with so many human narratives, and we collect “experiences” at a much faster rate than the average person. While some of these stories are hopeful, most are underlined by sadness and loss. And yet, I don’t benefit from 60-something years of character building. I haven’t been able to do a great retrospective review of the experiences I’ve gathered to better understand the existential arc of my life, as one might in their 70s. I am seeing the calamity here, right now. I see the end of illness and a long life, as in their 20s, and I don’t know what to do with it.

I ask right away: should I grieve with my patient and their family? Should I go back to work immediately? Don’t cry, or maybe a little? Why am I thinking so much of myself when the people in front of me are mourning? Longitudinally, I ask: In my personal narrative, where do I place the great amount of suffering I have been exposed to? Does it become an indelible part of who I am? Do these stories become anecdotes about anonymous people that I share when I meet people, in the same way lawyers discuss their clients or teachers with their students? Or do I hide these experiences in a less accessible part of myself, away from conscious access? It is a challenging process of identity building that we will have to go through as young doctors.

We are taught to establish empathetic relationships with our patients, but also to create professional boundaries to distance ourselves from the labyrinth of human grief. There are no specific rules for how to relate to patients’ tragedies. Every doctor does it differently. I have seen some physicians shed tears when discussing poor prognosis with their patients. I see some peppers maintain detachments. Many people neatly cross the line between compassion and emotional distance.

Doctors must devote a great deal of personal and psychological work to their relationship with human suffering. This relationship is not established overnight; It is constantly changing, and it is never perfect.

So here I am as a therapist in her 20s. I have my credentials. I present my wisdom and my knowledge of human pathophysiology. I am equipped with weak skills of empathy and compassion. But I have little to offer as fundamental wisdom or maturity to afflicted patients over the age of 40.

And yet, patients give me their deepest evidence. They trust me to treat them, heal their injured bodies. His storied body. Bodies, who have spent the better part of a century as residents of this physical world, hold decades of experience. The bodies that have served him well for many years are now before me – someone who knows so little about the scope of his life. These patients, these people, they allow me to treat them, and in doing so, allow their stories to be incorporated into my personality. And when I speak, they listen, and they call me “Doctor.”

Katherine Tabor is completing her medical residency in Michigan. © 2022 Chicago Tribune. Distributed by Tribune Content Agency.

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