My new friend, Amy Firth, shared a great TEDx Talk by Ursula King with me this weekend.
Amy Firth and I first bonded over our mutual love and admiration for Brene Brown and Elizabeth Gilbert. When Amy sent me this TEDx Video of ER doctor Ursula King discussing the lack of uncertainty and vulnerability in the medical field (and the intolerance of it), it got my mind turning.
It's true: Our western culture has made medicine into a very certain profession. As Dr. Kingsays, no one really wants a doctor who approaches health care or our diagnosis with uncertainty: we want our health care providers to be certain, to know what it is we need to help us return to our healthy state, and to reassure us.
I learned this behavior as a health care provider. If you aren't certain, you sure as hell better find someone who is.
Of course, there is a true necessity for certainty in medicine. The correct dose, the correct diagnosis. The surgery must happen on the correct patient, the correct side and correct site. We insist on surgical instruments in the operating room that have most certainly been sterilized. The certainty in which I confidently put an instrument into the hands of my surgeon. And the certainty in which the nurse slaps an instrument into my gloved hand as I assist. There is nothing quite like the sound of a cold metal instrument slapping into a warm, gloved hand with perfect timing.
Yes, certainty is a wonderful thing. But it has its therapeutic limits. The need for calculations, measures and studies can also create sterility in relationships between providers and patients. It can cause us to remove ourselves as providers from our own humanity and the humanity of those we care for.
Certainly these conversations about the need for humanity and empathy in medicine are happening. The need for vulnerability and space for not-knowing. Dr. King is a good example of this. Dr. Danielle Ofri and Dr. Lissa Rankin are also great examples. There are many more. Yes, the conversation has a table. A few of us are at it.
Certainty needs to be "right" and prides itself on being "good", "normal" and "safe". We, as both health care providers and as humans, love to emulate these ideas.
It doesn't take long, however, to see that calculated certainty is not the answer when a patient is sitting across from you, devastated with a new diagnosis. Or when you have to tell someone a test came back abnormal. Or when you are the only person they have told that they are hurting themselves because their life feels out of control. Or when the cancer has stopped responding to treatment.
There is no script. There is only what is.
When these situations first start to happen as a novice practitioner, you scan through your mental "certainty" folder. And it comes up empty. There is no "right" or "safe" or "good" or "normal". There is only the space between.
And the space between is often an invitation for vulnerability, empathy and uncertainty.
In those moments you cannot find the answer in a textbook. Some people can't stand this feeling, this uncertainty, so they end up responding in a calloused, robotic, non-therapeutic way.
This is not what medicine is about. Rather, I say, medicine is about healing, connection and whole-ness.
The most healing and resilient moments are born out of uncertainty, vulnerability and empathy.
But this asks of you, my fellow practitioners, to be willing to create a space to not know. To be willing to sit with the tears of another and not treat them as a disease that must be diagnosed. To be wiling to tap into your own hurt, your own past, your own experiences, to be able to find the empathy for another that resides in those cellular memories of your own being.
It will be in the beautiful dance between certainty and vulnerability where medicine will learn to truly heal.