by Willem Schott, MD
“They’re so close to the water but they’re not allowed to drink it.” This is how today’s physicians were described by David Elkin during an interview on The Nocturnists podcast. This particular quote, on a podcast about humanism in medicine, was trying to address part of the issue of physician burnout.
So, what was he talking about? Being so close to the water but not allowed to drink? And why might that be burning out physicians like myself? Well let’s try to not only answer those questions, but maybe even peek at a solution or two. Now, anyone who’s read my stuff knows I’m a sucker for analogy, and while I’m not breaking from that trend I would appreciate a little credit for not running this analogy all the way into the ground by pointing out that the water of humanism is one way to put out to the fire of burnout. But, I digress.
“They’re so close to the water, but they’re not allowed to drink it,” came through my headphones, while my dog trotted along. I let out a sigh, and then stopped in my tracks. The leash pulled tight as I looked up to the sky and shook my head. The words sunk into me, they resonated, they resounded my experience. You see, as healthcare providers we’re poised in an amazingly unique and potentially wonderful place to hear many stories, offer much healing, and genuinely impact lives. The problem we run into, however, is that instead of being able to experience this humanity, we’re left running alongside or staring at it from a distance, asking as few questions as possible to get the most out of our short clinical encounters.
Now medicine hasn’t always been this way or this bad, but with ever more complex medical records and healthcare systems combined with demands to see more patients in less time we really do struggle to find ways to connect with our patients. I may get a snippet about the war they fought in or the dog that’s waiting at home or the trip upcoming, but this barely wets my lips before I find myself redirecting towards the clinical crux that brought me in the room. I love the water analogy because when I think about a patient’s story as a body of water and the medical system as everything around it, it feels so real. Sometimes my patients’ stories feel like a river rushing by, so many socioeconomic factors pulling them away while I’m trying to screen and maintain their health. Other times my patients’ humanity feels like a quiet pond, sitting there ready to be discussed with me because maybe there aren’t many others asking. Sometimes patients’ stories look like a scary ocean, dark and deep and too dangerous to dip your toes into when the beach itself is already rocky.
Now whether we approach our patient’s humanity with intrigue or abstraction, or not at all, the reality remains that patients will keep coming. So if we’re lucky enough to interact with so many souls in so many unique phases of their life (especially in the setting of cradle-to-grave family medicine) how do we take back a taste of humanity? Well, some electronic medical records actually have sticky notes allowing us to jot down the names of kids, pets, favorite sports teams, etc… and I genuinely think this is a good start. A good reminder to view a person’s background before their medication list.
Sticky notes shape behavior but the real crux of this article is that we can and we should stop to take a sip of the vast and delicious humanity that we’re privileged enough to see as healers. We can approach our interactions with more reverence for the story than for the outcome. We can remind ourselves of one non-medical thing about a patient before we knock on their door or type away at their note. One final beauty of this metaphor is that like water being life-sustaining, these stories can be career saving
I’m lucky to get to meet the people that I do in so many ways and I don’t have to remind myself of every single one every single time. I don’t have to wade into the ocean of humanity and lose the medicine with the tide. But I can cup my hands in the rushing river and dip my toes in the still pond water. So if you’re feeling burned out, maybe reach back out to try and hold the humanity of medicine in your hands and take just a small sip. You might be surprised just how refreshing it can be.
Dr. Schott was born (Neenah) and raised in Black Earth, WI. He headed west to complete his undergraduate degree in Health Promotion and Education at the University of Utah before going back home for medical school at the University of Wisconsin School of Medicine and Public Health. His medical interests all center around caring for communities and families (cradle-to-grave intergenerational care) with specific interests in American Indian Health, Sports Medicine, and Geriatrics. He is also very interested in the One Health Project which is a “collaborative, multisectoral, and transdisciplinary approach—working at the local, regional, national, and global levels—with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment.” When not in clinic he loves engaging his community in meaningful ways including youth education, sustainable food development, and improving access to outdoor recreation. He has trouble sitting still and has hobbies that range from skiing to mountain biking to bluegrass music to volleyball to watching soccer to playing the banjo to water skiing to traveling to yoga and hiking. He chose the University of Utah because he fell in love with the Wasatch and couldn’t think of a better place to live and train, surrounded by inspiring people and views with unique opportunities around every corner. He loves how connected the University of Utah is to the surrounding valley and state and hopes to take advantage of every opportunity from 4th street clinic in downtown SLC to rural clinics across the beautiful state.