The Cost of Getting Killed on a Daily Basis

By Eric Warm M.D.

We got killed last night (no one died).

How many hits did you get? (no one got hit).

That outside hospital dropped a bomb on us (nothing exploded).

We describe our lives as if we at war. I have a hospitalist friend who tells me he goes radio-silent when he’s on service (meaning he won’t respond to emails).

Perhaps it’s gallows humor, or a shields-up defense mechanism, but it’s well known the words we say shape our world as much as the world shapes our words.

Evidence suggests medical culture ‘serially emphasizes the inherent bias to recognize and remember the negative.’ Once bitten twice shy syndrome? Pascal’s wager in our brains?

With experience, I’ve noticed that the point at which we use war terms is relative. When the team cap is 12, having 12 patients means getting crushed. When team caps are 16, having 12 patients feels like a walk in the park.

Last year I recall a particularly grueling day in the office where nothing went right. The early patients were late. The later patients were angry. The inbox overflowed with endless need. It took me 12 minutes to correctly order a pap smear. I plowed through it all and felt gutted by the end of it.  Why did it have to be such a battle to do my job? I was tired of fighting.

I left feeling besieged.

That night my father died suddenly while driving home from work. Bystanders got him out of the car and resuscitated him at the scene. He was transported to a small hospital and then to a big hospital I’d never been to.

I sat in the ICU and watched the monitors with my family.

At that moment, added to whatever else I was feeling, was this: I hoped none of the doctors and nurses in that unit were plowing through their day feeling gutted, embattled and besieged. Because my day in the office, now in perspective, seemed to be a totally different thing than what it was.

It might be the oldest lesson in the books – getting perspective.

The hard part is making the lesson last. It’s been a year — I still have bad days, but I try not to be at war with them.

To paraphrase Ian MacLaren (or Plato or Philo of Alexandria or John Watson): be kind; for everyone you meet is fighting a hard battle.