The patient and gentle invitation

Two years ago I was fortunate to spend five days at the Quest for Life Foundation and see the wonderful Petrea King at work. I joined a residential program with twenty others who were seeking peace, happiness and the healing of old wounds.

Many participants told horrifying stories of tragic loss, serious illness, violent abuse or other burdens that shaped their lives. I spoke of the trauma and brutalization I had experienced in my medical practice. What I learned from King was gentleness and non-judgment in the approach to peoples’ vulnerabilities.

My medical habits and expectations did not sit easily within a program that seemed so passive and so full of inactivity. The daily lunch break yawned from 1 until 3.30pm. At my hospital I usually grab a quick sandwich while working at my desk!

Each day began with an hour of relaxation and meditation. Our meals were prepared with seasonal organic food. Counseling and massage therapy were on tap. Slowly, day-by-day, the peace of the place dripped into you.

Petrea made no attempt to overcome resistance. In her infinitely gentle, compassionate and wise way, she simply bore witness to suffering. She invited participants to let go of past events and to stop fretting about the future. She called us all to “come to our senses” – literally to connect to the present moment through mindfulness and noticing our rich sensory experience.

As the days passed, I began despair that some of the participants would ever climb out of their anger, depression, anxiety, or self-loathing. One lady had spent four days curled up on the floor in a fetal position, hugging cushions. I wanted to push or challenge her.

But on the last morning of the program, she suddenly opened up like a flower. The transformation was complete – a new light in the eyes, a different posture and body language, and a remarkable change in her voice and her words. In that moment, I learned something profound about gentleness and non-resistance.

Alone with my shame

Every doctor has a case like this, where the guilt and shame burn on.

I was a new senior resident in anesthesia, rostered solo to anesthetize a patient for major vascular surgery. I’d worked in the hospital only a week and I didn’t know the surgeon or the operating room staff. I didn’t know where to find essential equipment and I was unfamiliar with local procedures and protocols. To make matters worse, all cases started late that day because the anesthesia department had a meeting.

My high-risk patient needed an arterial line, a central line and an epidural as part of the anesthetic management. I struggled with every procedure, wasting time. The waiting surgeon grew impatient, then angry, and stopped talking to me.

Both the surgery and the anesthetic went badly. The patient proved to have a sicker heart than pre-op tests predicted. I couldn’t control the blood pressure. The essential communication and coordination between surgeon and anesthesiologist was lost. The patient bled profusely. I struggled alone and didn’t call for help. Where I had trained in the UK, asking for help was not part of the culture.

In the middle of the day, one of the senior anesthesiologists stepped into my operating room. He said, ‘I noticed there was a new resident doing a major case alone so I thought I’d see if you needed help.’

He quickly realized I was in serious difficulty. He sent me out for a break and by the time I returned, he had greatly improved my patient’s condition. I was deeply grateful for his empathic support and practical help. While I was glad for my patient, I felt ashamed of my failings.

My patient went to intensive care and his condition gradually worsened. Every time I was on-call, this patient appeared on the list of acute cases for the operating room. I felt like he was haunting me. I took him two more times to the operating room for treatment of complications but his condition deteriorated. He died after a month in intensive care.

I’m sure it’s the worst anesthetic I have given. This patient’s death hangs on my conscience. I thought I was competent to do the case but have since come to understand that I was set up to fail on that day. No doctor could have performed well in those circumstances.

Experiences like this are traumatizing for the doctor, creating fear and vulnerability. Both my patient and I were abandoned by an unsafe system – save for my kindly rescuer. The patient’s relatives live with their loss, I with my shame.

My new role as the frightened parent of a critically injured daughter

In 2004, our teenage daughter Chloe crashed her car and was critically injured. She spent three months in spinal traction with a broken neck. The technical quality of care was excellent but some of her most basic human needs were neglected.

Chloe’s experience has been a major motivation for me to try to strengthen humanity and compassion in healthcare. Thankfully Chloe made a full recovery.

My memory of that first traumatic day is fragmented. As a clinician, I found myself in a familiar hospital setting. In my new role as the frightened parent of a seriously injured daughter, the hospital environment seemed alien and threatening.

My strongest memories of that fateful day are the small acts of kindness done by compassionate health professionals; they gave us indescribable comfort.

Chloe made many journeys within the hospital: from the trauma unit to the CT scanner; back to the trauma room; onwards to the operating theatre and to intensive care. During these potentially hazardous journeys, a transit nurse watched over her.

We felt so grateful for his loving care and attention. Not only did he carry all the equipment to monitor Chloe’s vital signs but he also anticipated her need for pain relief on the long journey. He came equipped with morphine and other drugs to relieve her distress.

But it is the memory of one act that still brings tears to my eyes. In the junction between hospital buildings there is a join in the floor. This caring nurse stopped Chloe’s trolley and individually lifted each wheel over the join to prevent her broken neck from being jolted.

Compassion is revealed in the smallest acts.

It is hard to express how profoundly vulnerable and fearful one feels for a loved one in mortal danger but these acts of exquisite kindness are the things that make you feel safe.

As parents of a seriously injured teenager, we felt very lost in the strange hospital environment. This wonderful nurse took us by the hand and led us to the places we needed to be.

In the months that followed, on bad days when Chloe was suffering the most, this nurse would magically appear in her room to offer comfort. Nobody called. He just intuitively sensed when his presence was needed.