Performance & Empathy: A Concert in the OR

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The following blog contains content depicting graphic moments in an operating room. Reader discretion is advised.

A harsh, penetrating glare in the operating room: spotlights, focused on the body on the table.

Our patient was an Alaskan outdoorsman. He was older, and wiry. His scraggly beard rivaled Gandalf’s, and his long limbs splayed unnaturally in front of me. He was losing his leg today.

Years of uncontrolled diabetes and hypertension brought him here.

We covered his face with a sheet and I wondered: “Is this a precaution to keep a sterile field, or to help the surgeons disassociate from the person and focus on the task?”

The concert is about to begin.

The spotlight narrowed in on his blue leg. Instruments were tuned and perfectly laid out as the surgeon raised her double-gloved hand, ready to conduct her team into action. Then we began.

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Adrenaline rushed over me as she handed me the saw. I barely flinched as fragments of bone pelted against my glasses. The pooling blood created a stark contrast against the crisp interior of the room. I could taste copper and realized I had bit my tongue.

Hands dancing, I tied off vessels. Then I handed the leg to the scrub tech.

My surgeon looked at me. “We’ll have many more of these cases by the time your rotation is done,” she said. I smiled. “Cool.”

Cool? That response is still smacking me in the face.

How had I so quickly forgotten about the human whose life would be drastically changed forever?

The last thing he had said to me was how he couldn’t wait to get back to fishing. He was expectantly hopeful about his prosthetic. I was excited about the prospect of performing another amputation. I felt ashamed.

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The juxtaposition between removing yourself from the person in order to perform and remaining empathetic and cognizant of the human soul is one that often feels evasive in medicine. As doctors, we are trained to carefully manicure our emotions, so they don’t get in the way of our performance. And yet we are expected to build rapport, ask collaborative questions and connect compassionately with our patients. No wonder we have so many burnt out physicians. The double standard is glaring.

I’m just starting my journey, discovering what I am capable of and who I want to be as a human and a doctor. I don’t have an answer to balancing performance and empathy but, for now, I’m just going to let myself feel. I’m going to go for a walk. I’m going to relish the beauty and strength of my legs propelling me forward. And I’m going to always remember that concert in the OR.

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Annika LaVoie

Third-Year Osteopathic Medical Student (OMS III)

Family Medicine Interest Group – ACOFP Student Chapter President

OB/GYN Club - Secretary

Association of Women Surgeons - National Liaison

Pacific Northwest University of Health Sciences

Annika LaVoie