How to Avoid Hitting the Wall

A guest blog entry written for the Society of Laprascopic Surgeons. 
 
A strong, healthy looking young man walked into the ER complaining of a bad asthma attack. A friend of mine, Peter, who had recently qualified as a nurse was part of the team that cared for him. They did everything they could, but his asthma attack had progressed too far and fast and he had waited too long to seek help. Despite valiant efforts by the team he died. Peter felt like he had hit a wall of grief and guilt.  It was a stark moment for him. That night he went home and sank into a warm bath, crying about what he had witnessed.
 
Just a young priest at the time I did not know what to say to Peter when he told me the story. I sat with him quietly as he talked about his experience and how it had made him feel. He wondered whether he could have done more. He felt guilty. He remembered the patient being about his own age, and looking strong when he walked in to the ER. He could not believe the fact that a few hours later he was dead.
 
I didn’t know what to say at the time so I just listened. Looking back, I hope Peter knew the following as he reflected on this young mans death. I offer these reflections to you also.
 
Do Your Best
You have been given skills and training that make you the practitioner you are, do your best with those gifts. That is all that can be asked of you. Your skill as a healer is what your patient needs, so apply it with all of your energy. On occasion it is not going to be enough, but do all you can.
 
Remember Your Team
You are part of a team and your whole team works together to heal patients. In Peter’s case, no one person was responsible for the loss, and no one could have stopped it.
 
If we take personal responsibility for saving every life we encounter it will create an impossible burden for us to bear. Share the load of work with your team and share the load of emption when a patient dies with someone who will listen carefully, a priest, pastor, therapist or rabbi.
 
Remember you are part of a team that extends beyond the walls of the OR. There are chaplains and social workers, family and friends who all contribute to the healing of patients. Learn to recognize the gifts of each and see yourself as a part of a whole. It is in community that we care for the sick. It is also in community that we can receive healing ourselves when we encounter loss.

Let Your Role Carry Some of the ‘Weight’
You are a surgeon, so become fluent in understanding your ‘role’. Be aware of the capacity and limitations of your role and let your role carry some of the weight of the difficult choices you must face.
 
The role you occupy has a standard of practice associated with it; you had to train to enter into it, and you know what you are meant to do when you occupy it.
 
When I walk into a traumatic pastoral situation I always remember that I am walking in as a priest. I am not just Matthew Woodward, a friendly, slightly dippy guy who wants people to feel good. I may have to hear things that are hard to hear, or say things that are difficult to say, so I need to remember my role and listen and speak as a priest.
 
You may think I am detaching somewhat and hiding behind my role, but it is not insensitive or dismissive to say that I am being a priest when a priest is what is needed. A surgeon is what is needed in the OR. If I didn’t acknowledge my role and let it carry some of the weight I would be crushed by the responsibility. So, I contemplate what it means to be in my role every day when I put on my clerical collar.
 
Take a moment to do that; contemplate what it means to be a surgeon every time you start a shift, when you put on your scrubs, or when you step into the OR. Be mindful of it and let your role carry some of the weight of what it is you have to do.
 
Recap
What is the alternative to these three suggestions? Well, you might think that you are personally responsible for every life you encounter, you may imagine that you are solely responsible for every healthcare choice that someone else makes, and you could imagine you have the capacity to bend the laws of nature and make impossible outcomes occur. But none of that is real…
 
In order to avoid crashing into a wall of grief and guilt I recommend you get to know who you are and embrace your limitations; know what your role is; know who your team are; and, always do best with your skill and training.
 
Having said all of this, difficult moments will still take place: not every patient survives. The most important thing I can recommend when that happens? Be gentle with yourself and try to find someone at the end of the day that will listen to you as you tell him or her how you feel.
 
The Rev. Matthew Woodward leads Transfiguration Episcopal Church in San Mateo, California. He is originally from the UK and over the years has tried to learn to listen more than speak when people are telling him how they feel.   http://www.transfig-sm.org