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Another life saved
The Journal of EmergencyMedicine, Vol13, No 1, pp 91-93, 1995 Copyright 0 199sEkwier ScienceLtd Printed in the USA. All rights reserved 0736-4679/95 $9.50 + .OO
Pergamon 0736~4679( 94)00114-6
Emergency Forum
ANOTHER
LIFE SAVED
Richard F. Edlich, MD, PhD Department of Plastic Surgery and Biomedical Engineering, University of Virginia School of Medicine, Charlottesville, Virginia Reprint Address: Dr. Richard F. Edlich, Department of Plastic Surgery, Box 332, Charlottesville, VA 22901
The concept of “specialness” of physicians has been recognized for centuries. The Scottish author Robert Louis Stevenson described the personal traits of a physician that we should try to emulate, although few of us achieve such excellence. He became a connoisseur of physicians during his illness with tuberculosis. In his dedication to his volume Underwoods, Stevenson ( 1) expressed his opinion of physicians:
powerful influence on their lives. My early admission to college at age 15 and medical school at 18 years gave me an unfounded confidence that I would achieve the same elements of style possessed by them as well as other physicians described by Stevenson. When I graduated from medical school at age 22, I realized that a logical extension of this concept of “specialness” is that I should have unlimited energy to spend at work. There is a clear precedent for this unrealistic concept in the behavior of my academic mentors who seemed to deny that time and energy have limits. The need to set priorities in my life became especially evident when I married my beautiful wife, Carol, during my fourth year of medical school. Because a priority in my life was the development and enjoyment of an intimate relationship with my wife, spending quality time at home was an essential part of my life. With the birth of our three children, I have been committed to being a partner in parenting. By my activities and efforts, I wanted to assure my wife and children of their importance to me. Without this explicit reassurance, it is easy for the family of a physician to feel that they are remote in importance compared to the physician’s work, and to feel guilty if they take this essential person away from the patients, whose needs are so serious and immediate (2,3). I also
There are men and classesof men that stand above the commonherd; the soldier, the sailor, and the shepherdnot infrequently; the artist rarely; rareher still, the clergyman; the physician almost as a rule. His is the flower (such as it is) of our civilization; and when that stageof man is done with, the only rememberedto be marvelled at in history, he will be thought to have sharedaslittle asany in the defectsof the period, and most notably exhibited the virtues of the race. Generosity he has, such as is possibleto thosewho practice an art, never to those who drive a trade; discretion, tested by a hundred secrets; tact, tried in a thousand embarrassments; and what are more important, Heraclean cheerfulnessand courage.So it is that he brings air and cheer into the sick-room, and though not as often as he wishes,bringshealing.
As a child, my perceptions of a physician were consistent with the laudatory comments of Stevenson. My beliefs arose from my admiration for my grandfather and father who were physicians with successful practices in New York City. My perceptions of them were confirmed by many of their patients who sought me out to acknowledge them for their RECEIVED:
19 January 1993; ACCEPTED:
tried to participate in recreational programs, distinct
from my professional activities, that centered and invigorated my mind and nurtured my soul. These physical activities made me more productive in my personal and professional life and seemed to help me cope emotionally with issues of living and dying.
8 February 1994 91
92
Faced with escalating demands for clinical productivity, a successful research program, teaching, and scholarly work, I began to spend an increasing amount of time pursuing my professional career. Without hesitation, I abandoned my recreational activities, while protecting the quality time spent with my wife and family. Because of my limited adolescent experiences, I did not appreciate the emotional repercussions of this decision. Unknown to me, I was on the treadmill of academic medicine accelerated by the incredible advances in biotechnology, unable to free myself from the tyranny of time. I became so focused on the outcome of my efforts that I was not present to the process of living. I first experienced the “full catastrophe of living” after my first exacerbation of multiple sclerosis in February 1985 (4). With the development of paraparesis that prevented me from pursuing my surgical career, future dreams and hopes about my professional life vanished. When I heard Kabat-Zinn’s (4) concept of “the full catastrophe of living,” I felt that this concept embodied a complete appreciation of life’s dilemmas, sorrows, and tragedies coupled with an understanding of the human spirit’s ability to grow in strength and wisdom, in spite and due to life’s injustices. For Kabat-Zinn, “facing the full catastrophe means finding and coming to terms with what is most human in ourselves.” He encourages us to learn and practice the art of embracing the full catastrophe. Rather than destroying or robbing us of our power, the storms of life will strengthen us as they teach us about living. A personal transformation in my life occurred by the regular, discipline practice of moment-to-moment awareness, or mindfulness, the complete owning of each moment of my life. Prior to my illness, I had wasted enormous amounts of time reacting unconsciously and automatically to the world. I soon realized that my concerns about death were a cover-up for my fear of living. I began to see the way that I was living and the changes that I would have to make to enhance the quality of my life and nuture my soul. The personal recreation and play that I had abandoned were the first activities that I restored in my life. Because my limited mobility did not allow me to participate in competitive sports, I have immersed my life in artistic and sporting events, which I enjoy with dear colleagues and friends. The value of participating consistently in annual events in our community has become an integral part of my personal transformation. I have been thrilled by the annual Virginia Film Festival of American Film at the University of Vir-
R. F. Edlich
ginia, which is a unique and nationally significant cultural event featuring serious discussions and academic exchange about America’s liveliest art. Its success has been attributed to its clear definition of its role as a study of American film. There are three genres of American film, musicals, westerns, and this year’s theme “ Film Noir: Through a Lens Darkly.” The term “film noir” is used today to describe Hollywood films of the 1940s and 1950s. The smoke-filled films portrayed that dark and gloomy world of crime and corruption. Films in which it is often hard to distinguish heros from the villains. They are both pessimistic, cynical, and disillusioned. Robert Mitchum was this year’s star attraction as one who embodies “film noir.” Mitchum, with those heavy-lidded eyes that have seen it all, epitomizes cool. Mitchum’s career has spanned half a century. He has played a variety of characters, good guys, bad guys, sensitive guys, but whatever the role, each has been unmistakenly stamped a Mitchum character. Roger Ebert also led a three-part 6-h workshop of a shot-by-shot analysis of one of the world’s greatest films: Billy Wilder’s “Sunset Boulevard” ( 1950). This workshop allowed me to broaden my understanding of the choices, techniques, and strategies used to create the expressive power of a film. I gave Ebert a “thumbs-up” for his superb course. I now attend each Fall Convocation on the Lawn of the University of Virginia. During the Convocation, intermediate honors are bestowed on undergraduate students who have a grade point average of 3.4 or better in their first four semesters. This year’s Convocation speaker was Rita Dove, Commonwealth Professor of English at the University of Virginia. Early this year, Rita was installed as Poet Laureate of the United States. She is the youngest person and the first African American to be so honored. In 1987, Rita won the Pulitzer Prize for “Thomas and Beulah,” a collection of stories based on the lives of her maternal grandparents. In her speech, she reminded us that poetry makes the inner life of an individual known to others. “Through poetry, we can experience empathy, a communion to the souls.” She also stressed the importance of multicultural education, citing an African proverb, “It takes an entire village to educate a child” the proverb states. Villages takes many forms, from neighborhoods to global communities. Rita indicated that “we will remain children in some of these villages, continuing to be educated while educating others.” After her speech, I especially enjoyed the reception, at which I met the proud parents and congratulated the student scholars. My new season tickets to the Virginia Cavalier
Another Life Saved
93
football games are invitations to a great social event for faculty, students, and alumni. The festivities of our tailgate parties often exceed the excitement of the game. My season tickets to our basketball games are other opportunities to meet new students and faculty and strengthen old friendships. These inspirational social activities have provided me with the opportunity to walk along the path of my own life with my eyes awake, instead of half unconscious, responding consciously to the world instead of automatically. My goal is to find my own way, sailing with the winds of change. I know that I am on a life-long journey along a path that ultimately leads only to an understanding of who I really am.
Spielman (5), an anesthesiologist, has written about his own journey outside of medicine that has brought new meaning to his life, “One Life Saved.” His path includes reading for pleasure, collecting serigraphs, rugs, and pottery, as well as participation in men’s support group. His spiritual prescription has saved his life as a human “being,” rather than as a human “doing.” Although my journey is different, I can see that another life has been saved.
Acknowledgment-This research was supported by a generous gift from Virginia E. Holt, Lynchburg, VA.
REFERENCES 1. Stevenson RL. Underwoods. New York: Charles Scribner’s Sons; 1895:91. 2. Fabri PJ, McDaniel MD, Gaskill HV, et al. Great expectation: stress and the medical family. J Surg Res. 1989;47:379-82. 3. Gerber LA. Married to their careers: career and family dilemmas in doctors’ lives. New York: Tavistock Publications; 1983.
4. Kabat-Zinn J. Full catastrophe living. Using the wisdom of your body and mind to face stress, pain, and illness. New York: Dell Publishing; 1990. 5. Spiehnan FJ. Questions and reflections. One life saved. Pharos Alpha Omega Alpha Honor Society; 1993:56:40.
Pergamon 0736~4679( 94)00114-6
Emergency Forum
ANOTHER
LIFE SAVED
Richard F. Edlich, MD, PhD Department of Plastic Surgery and Biomedical Engineering, University of Virginia School of Medicine, Charlottesville, Virginia Reprint Address: Dr. Richard F. Edlich, Department of Plastic Surgery, Box 332, Charlottesville, VA 22901
The concept of “specialness” of physicians has been recognized for centuries. The Scottish author Robert Louis Stevenson described the personal traits of a physician that we should try to emulate, although few of us achieve such excellence. He became a connoisseur of physicians during his illness with tuberculosis. In his dedication to his volume Underwoods, Stevenson ( 1) expressed his opinion of physicians:
powerful influence on their lives. My early admission to college at age 15 and medical school at 18 years gave me an unfounded confidence that I would achieve the same elements of style possessed by them as well as other physicians described by Stevenson. When I graduated from medical school at age 22, I realized that a logical extension of this concept of “specialness” is that I should have unlimited energy to spend at work. There is a clear precedent for this unrealistic concept in the behavior of my academic mentors who seemed to deny that time and energy have limits. The need to set priorities in my life became especially evident when I married my beautiful wife, Carol, during my fourth year of medical school. Because a priority in my life was the development and enjoyment of an intimate relationship with my wife, spending quality time at home was an essential part of my life. With the birth of our three children, I have been committed to being a partner in parenting. By my activities and efforts, I wanted to assure my wife and children of their importance to me. Without this explicit reassurance, it is easy for the family of a physician to feel that they are remote in importance compared to the physician’s work, and to feel guilty if they take this essential person away from the patients, whose needs are so serious and immediate (2,3). I also
There are men and classesof men that stand above the commonherd; the soldier, the sailor, and the shepherdnot infrequently; the artist rarely; rareher still, the clergyman; the physician almost as a rule. His is the flower (such as it is) of our civilization; and when that stageof man is done with, the only rememberedto be marvelled at in history, he will be thought to have sharedaslittle asany in the defectsof the period, and most notably exhibited the virtues of the race. Generosity he has, such as is possibleto thosewho practice an art, never to those who drive a trade; discretion, tested by a hundred secrets; tact, tried in a thousand embarrassments; and what are more important, Heraclean cheerfulnessand courage.So it is that he brings air and cheer into the sick-room, and though not as often as he wishes,bringshealing.
As a child, my perceptions of a physician were consistent with the laudatory comments of Stevenson. My beliefs arose from my admiration for my grandfather and father who were physicians with successful practices in New York City. My perceptions of them were confirmed by many of their patients who sought me out to acknowledge them for their RECEIVED:
19 January 1993; ACCEPTED:
tried to participate in recreational programs, distinct
from my professional activities, that centered and invigorated my mind and nurtured my soul. These physical activities made me more productive in my personal and professional life and seemed to help me cope emotionally with issues of living and dying.
8 February 1994 91
92
Faced with escalating demands for clinical productivity, a successful research program, teaching, and scholarly work, I began to spend an increasing amount of time pursuing my professional career. Without hesitation, I abandoned my recreational activities, while protecting the quality time spent with my wife and family. Because of my limited adolescent experiences, I did not appreciate the emotional repercussions of this decision. Unknown to me, I was on the treadmill of academic medicine accelerated by the incredible advances in biotechnology, unable to free myself from the tyranny of time. I became so focused on the outcome of my efforts that I was not present to the process of living. I first experienced the “full catastrophe of living” after my first exacerbation of multiple sclerosis in February 1985 (4). With the development of paraparesis that prevented me from pursuing my surgical career, future dreams and hopes about my professional life vanished. When I heard Kabat-Zinn’s (4) concept of “the full catastrophe of living,” I felt that this concept embodied a complete appreciation of life’s dilemmas, sorrows, and tragedies coupled with an understanding of the human spirit’s ability to grow in strength and wisdom, in spite and due to life’s injustices. For Kabat-Zinn, “facing the full catastrophe means finding and coming to terms with what is most human in ourselves.” He encourages us to learn and practice the art of embracing the full catastrophe. Rather than destroying or robbing us of our power, the storms of life will strengthen us as they teach us about living. A personal transformation in my life occurred by the regular, discipline practice of moment-to-moment awareness, or mindfulness, the complete owning of each moment of my life. Prior to my illness, I had wasted enormous amounts of time reacting unconsciously and automatically to the world. I soon realized that my concerns about death were a cover-up for my fear of living. I began to see the way that I was living and the changes that I would have to make to enhance the quality of my life and nuture my soul. The personal recreation and play that I had abandoned were the first activities that I restored in my life. Because my limited mobility did not allow me to participate in competitive sports, I have immersed my life in artistic and sporting events, which I enjoy with dear colleagues and friends. The value of participating consistently in annual events in our community has become an integral part of my personal transformation. I have been thrilled by the annual Virginia Film Festival of American Film at the University of Vir-
R. F. Edlich
ginia, which is a unique and nationally significant cultural event featuring serious discussions and academic exchange about America’s liveliest art. Its success has been attributed to its clear definition of its role as a study of American film. There are three genres of American film, musicals, westerns, and this year’s theme “ Film Noir: Through a Lens Darkly.” The term “film noir” is used today to describe Hollywood films of the 1940s and 1950s. The smoke-filled films portrayed that dark and gloomy world of crime and corruption. Films in which it is often hard to distinguish heros from the villains. They are both pessimistic, cynical, and disillusioned. Robert Mitchum was this year’s star attraction as one who embodies “film noir.” Mitchum, with those heavy-lidded eyes that have seen it all, epitomizes cool. Mitchum’s career has spanned half a century. He has played a variety of characters, good guys, bad guys, sensitive guys, but whatever the role, each has been unmistakenly stamped a Mitchum character. Roger Ebert also led a three-part 6-h workshop of a shot-by-shot analysis of one of the world’s greatest films: Billy Wilder’s “Sunset Boulevard” ( 1950). This workshop allowed me to broaden my understanding of the choices, techniques, and strategies used to create the expressive power of a film. I gave Ebert a “thumbs-up” for his superb course. I now attend each Fall Convocation on the Lawn of the University of Virginia. During the Convocation, intermediate honors are bestowed on undergraduate students who have a grade point average of 3.4 or better in their first four semesters. This year’s Convocation speaker was Rita Dove, Commonwealth Professor of English at the University of Virginia. Early this year, Rita was installed as Poet Laureate of the United States. She is the youngest person and the first African American to be so honored. In 1987, Rita won the Pulitzer Prize for “Thomas and Beulah,” a collection of stories based on the lives of her maternal grandparents. In her speech, she reminded us that poetry makes the inner life of an individual known to others. “Through poetry, we can experience empathy, a communion to the souls.” She also stressed the importance of multicultural education, citing an African proverb, “It takes an entire village to educate a child” the proverb states. Villages takes many forms, from neighborhoods to global communities. Rita indicated that “we will remain children in some of these villages, continuing to be educated while educating others.” After her speech, I especially enjoyed the reception, at which I met the proud parents and congratulated the student scholars. My new season tickets to the Virginia Cavalier
Another Life Saved
93
football games are invitations to a great social event for faculty, students, and alumni. The festivities of our tailgate parties often exceed the excitement of the game. My season tickets to our basketball games are other opportunities to meet new students and faculty and strengthen old friendships. These inspirational social activities have provided me with the opportunity to walk along the path of my own life with my eyes awake, instead of half unconscious, responding consciously to the world instead of automatically. My goal is to find my own way, sailing with the winds of change. I know that I am on a life-long journey along a path that ultimately leads only to an understanding of who I really am.
Spielman (5), an anesthesiologist, has written about his own journey outside of medicine that has brought new meaning to his life, “One Life Saved.” His path includes reading for pleasure, collecting serigraphs, rugs, and pottery, as well as participation in men’s support group. His spiritual prescription has saved his life as a human “being,” rather than as a human “doing.” Although my journey is different, I can see that another life has been saved.
Acknowledgment-This research was supported by a generous gift from Virginia E. Holt, Lynchburg, VA.
REFERENCES 1. Stevenson RL. Underwoods. New York: Charles Scribner’s Sons; 1895:91. 2. Fabri PJ, McDaniel MD, Gaskill HV, et al. Great expectation: stress and the medical family. J Surg Res. 1989;47:379-82. 3. Gerber LA. Married to their careers: career and family dilemmas in doctors’ lives. New York: Tavistock Publications; 1983.
4. Kabat-Zinn J. Full catastrophe living. Using the wisdom of your body and mind to face stress, pain, and illness. New York: Dell Publishing; 1990. 5. Spiehnan FJ. Questions and reflections. One life saved. Pharos Alpha Omega Alpha Honor Society; 1993:56:40.