The Art in the Science
This week I had a patient that wasn’t doing well. Despite my best efforts he didn’t respond well to treatment, and contrary to the desired outcome of giving him relief, he felt worse. My only hope when I go to work every day is to be in service. If I could have one superpower, it would be to heal. As a practitioner that deeply cares about her patients, this felt like the worst case scenario.
When a patient doesn’t do well, I fret. I lie awake at night a worry about them. I think about what went wrong, what I missed, what could I have done better? My brain tells me I am “not good enough”.
Counterintuitively this self-depricating perspective is self-centered. It’s ego talking. Successes and failures, compliments and criticism, are two sides of the same coin. If it’s mine to earn, it’s mine to lose. So trying to convince myself about all the ways I’m doing well and helping people, paradoxically highlights all the things I perceive as my deficits and the people who are not doing as well. Neither are helpful.
This thinking highlights a loss of perspective. In reality, there are so many factors that are out of my control and bigger than me. The body, after all, is complex. Timing, stress load, sleep, belief systems, inflammatory state, life circumstances, trauma, prior experiences, nervous system tone… so many factors beyond the physicality of the pain. In fact, the mystery of that complexity, is what I love about working with people.
On the show “My Next Guest Needs No Introduction With David Letterman” Barack Obama reflected to his host, “Don’t you say to yourself ‘Boy, am I lucky?’ One of the things that I think I always am surprised by is when I see people who have been successful in business, or entertainment or politics and they’re absolutely convinced that it’s all because they were so smart. And I’m always saying ‘Well, look, I’ve worked hard and I’ve got some talent, but there are a lot of hardworking talented people out there.’ There was this element of chance to it. There was this element of serendipity…. “
There have been moments in my life when I’ve forgotten to pay homage to that chance, serendipity, opportunity… grace. Call it luck or divine intervention or privilege, but my life has been shaped by powers beyond me. And yes, I’ve tried to live in a way that fully embraces the opportunities I have been gifted. But I sometimes forget to appreciate that those chances are just that…gifts.
But there are moments when I remember. I try to write thank you notes of deep appreciation, for my unsung heroes, the earth angels, or people in my life that have profoundly impacted the trajectory of my life. There are videos such as these, that highlight my inherited privilege, and stop me in my tracks:
So if I haven’t earned any of this, why am I here? What am I meant to do with this great privilege of getting to be a physiotherapist that gets to work with people? If a patient doesn’t do well as a result of my treatment, how am I supposed to hold space for that without taking it on a personal failing?
If luck, grace, timing, and complexity helped build my life and career… Then those same forces are present in every clinical encounter. This “prayer” or quote by Richard Wagamese, resonates most deeply for me and it’s something that articulates my hope for all interactions: “Today, once again, I surrender my gift to Creator and ask that it be directed, channelled through me, every word, [every action]… guided by Her intention”.
My promise to my patients is this…
I will show up and be present
I will be curious and ask questions
I will continue to learn for life and share what I’ve learned with you
I will admit when something isn’t working and change course
I will be open to your feedback so that I may continue to grow as a practitioner
I will do my very best.
The rest is out of my control.