Suffering

By: Zainab Furqan – Class of 2015

When I was checking vitals I suggested a smile.
You didn’t talk for a while, you were freezing.
You said you hated my tone, it made you feel so alone,
and so you told me I ought to be leaving.
The Antlers

One of the reasons that I hesitated to go into medicine was the difficulty of coming face to face with suffering on a daily basis. In preparation for my medical school interview, I thought about my weaknesses and genuinely came to the conclusion that getting too close to my patients, and subsequently feeling saddened by their suffering, would be one of the most difficult challenges for me (Of course, I was told that this was too cliché of a weakness and that I should come up with something else, which I did).

Suffering is an essential characteristic of medicine. In the clinic, the patient  grants the physician entry into her own microcosm, reveals her vulnerabilities, her weaknesses, which are often the most difficult parts of ourselves to reveal. And yet, the point at which these vulnerabilities are revealed is when we draw closest to other people and establish some of the most rewarding of relationships.

I have reflected on my own sense of vulnerability when talking about my weaknesses and my fears. And I have realized that when I am doing so, a deep and profound imbalance of power is created. The listener, at this point, has immense power to dismiss, sadden and even break the person divulging his/her suffering. The listener also has the power to be a theraputic presence, to enter some of the deepest and most hidden parts of a person’s world and stand in solidarity with them, in a way that few others can.

It is easy for doctors to burn out as they listen to heartbreaking stories and are confronted with degenerating situations that they have no power to change. It is natural to build barriers and defense mechanisms- natural and sometimes necessary. Recently, in a clinical skills session, our group saw a patient who was in extreme distress. We were asked to perform a physical exam on him but a few of us felt uncomfortable and voiced this concern. Our clinical skills preceptor was adamant about performing the exam so we quickly listened to his breath sounds and moved on, disturbed and a little unsettled by what we perceived to be a lack of empathy.

Recently, I’ve been thinking about becoming hardened to suffering. Incidentally, I relistened to an album called ‘Hospice’ by the Antlers- it’s a beautiful musical journey through the relationship between a patient and her caregiver, the hospice worker, and each of their sufferings. The music allowed me to reconnect with the emotions that arise due to illness, in a way that I hadn’t been able to for a while, perhaps because I had been seeing many patients, hearing difficult stories and becoming slightly desensitized. As I was listening to this album, I realized I had built a barrier, which allowed me to cognitively process the stories that I had been hearing while maintaining distance from the emotions that those stories would elicit. The album broke down that barrier, linking my semantic understanding of the story being told through the lyrics with the emotional response elicited by the heart-wrenching melodies. It forced me to reflect on my own interactions with patients and critically evaluate whether I had become colder, less empathetic or more dismissive in my recent encounters.

The experience reminded me about why Medical Humanities can be so powerful; the field has the potential to reconnect doctors with their own humanity and that of their patients. Because sometimes, seeing suffering day after day, we separate the human being from the suffering, mistakenly viewing it as something that occurs in a vacuum. Medical humanities can act as powerful bridges, using art to bring us back to our patients.

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