Saving lives

We as physicians often struggle with failure. We struggle with its definition, its implications, its relevance. And most of all we struggle at times with the isolation of not many being able to comprehend our sense of failure from our perspective. 

What is failure to us? And why do I say it is strangely isolating for us?

In order to answer this, let’s go back a little to when we were not physicians. 

In India we start our education in medicine right after high school, as young, boisterous seventeen and eighteen year olds — that age, which many believe to be the age of extreme youth and perhaps allowable mistakes of growing up. As nerdiness goes, we dont exactly mind not having the extra few years of college to make those very mistakes; however, many of us land in this field initially simply because we are good in certain sciences and are able to ace some exceedingly competitive exams. Our initial benchmark for failure is similar to how we learnt to grade ourselves in school — academic failure is a failure and that is all. This benchmark gets rubbed in over and over again — in each college level exam we must pass in medical college, each post graduate exam we must clear in order to receive the chance to specialize, and then each time we look for a certain job in a highly competitive market. At each step the bottle neck keeps getting narrower so only the fittest survive, and scoresheets full of percents, percentiles, absolute values — numbers and more numbers — get drilled into us as a mark of expertise and success. 

So far, probably doesnt sound too different from some other professions out there, except maybe, just maybe, the actual length of this grind alone. 

However, that’s not all of it. Somewhere along this line, it is this length of education with its constant battle of science and art, man and machine, human and inhuman, numerical and amorphous; that shapes us into far more complex beings than how we originally start as just some smart kids scoring points.

We learn to shoulder responsibility alone. Oh never mind the swiss cheese patterns and systems failure analyses  —  no one yet has shared our malpractice or the burden of the ‘doctor’s signature’ — so yes, we do shoulder responsibility completely alone. We learn to partner in a patient’s grief and a family’s sense of loss. We realize that we must walk the line of professional control and judgement and yet establish an emotional connection with the human in our patients if we want to keep scoring better than their maladies. And then slowly our definition of failure begins to change…

Sometimes, we feel that we must be failing if there is a single error anywhere in the system — why? — because we school ourselves into being solely responsible. Sometimes, we feel that we must be failing if we cannot quite understand a patient’s very human fears of some treatment recommendations. And of course we feel like immense failures when we seem to fail on all counts and cannot score against a patient’s final malady for all the reasons I just wrote. 

But it is in times of human calamities, and natural disasters like now that we must absolutely look beyond and understand when do we really fail as physicians, and as human beings. It is vital to our sense of being and our sense of ongoing duty and fulfillment that we understand this, as should anyone else who wants to be doctored by a true doctor at heart.

We only fail if we don’t make our best efforts, whatever those best efforts may be. It is this and only this that makes us morph from intelligent students to wise physicians, and this and only this that is in our control. We are designed to treat. We first learn to treat in body. Gradually we learn to treat in mind as well. We are not designed to be able to provide a cure. That magic resides only in something beyond us. 

And so, even when we make our best effort we may not always be able to save a life — but we will save a soul — each time, and every time. And that soul, by God’s grace will not be just the patient’s … it will be ours. We will not have failed.