Making time to talk and listen
It was a retreat of the university’s department of psychiatry, at the university — a faculty development workshop titled something like, “Improving our educational impact — better teaching, better outcomes.” A retreat? I would have preferred we called the meeting an advance.
About 30 faculty members had signed up for it — psychiatrists and other mental-health workers, researchers, scholars — gathered for a day to become better educators. They were responsible for medical student teaching, residency training, and the education of their colleagues in the community. Keen educators, they were anxious to advance competency in teaching and along with it, their field. At any other time, the coffee-heavy pre-workshop gathering would have been full of enthusiastic conversation about mutual patients, teaching issues, research findings — a seedbed of academic work.
This conversation was different however; it was Sept. 12, 2001.
We all remember where we were on 9/11, though the next day may be hazy. Not this one, for me at least. I had flown in from Boston late in the evening before, one of the last planes out for many days. I was as keen as the workshop participants; I was the department’s guest and workshop leader that day.
As I began the workshop — offering a brief welcome, an outline of the goals of the day, a walk-through of the agenda — one of my colleagues put up his hand.
“Dave,” he said, gently; my colleague was (and is) a true gentleman. And wise, too. “Don’t you think we should debrief about what happened yesterday? Get our feelings out in the open? I don’t think we’ll ever achieve our goals if we don’t.”
He was right. There were nods around the room. For the next hour, perhaps hour and a half, we did exactly that. We heard stories of family members not reached for hours, of missing or lost friends-offriends, of flights delayed, of friends and family stranded. We heard concern about what this might do to our Muslim colleagues, decent, peaceful Canadians. Most importantly, we were caught in an outpouring of sadness and surprise, of the tragedy and chaos of the Twin Towers and the other enormous losses, especially the lives.
Only then could we start the workshop.
I was thinking about that day recently, triggered by two events. First, there was a lot of focus on events surrounding the 20th anniversary of 9/11. Secondly, I was triggered by a recent encounter with a physician at one of our big teaching hospitals, a fourth-year internal medicine trainee, someone who would have shouldered much of the burden of care over the last 18 months.
I was the patient. “How are you?” I asked after she had finished her examination and history-taking. “You and your colleagues?” I was thinking of the ER docs and nurses, the ICU staff, a long list.
Her eyes suddenly brimmed with tears. On that beautiful fall day, sunlight had managed to brighten the grey hospital clinical examination room. It caught her tears perfectly, making them glisten. Given our mask-wearing, it was the only element of emotion I could view.
Surprised I think, words tumbled out, touching on the fear she and her colleagues felt, the decisions they made, the ethical dilemmas they faced, the rapid out-of-control flood of patients. The deaths. Suddenly, the words stopped, halted by the fact that I was the patient, not the doctor, and by the pressure of time. Her response was natural and professional, but it carried an important lesson.
We better make time. We better listen to these colleagues, the brave, tireless nurses and doctors, the residents and students, the respiratory technicians, the many others. We better listen to the pain of so much human life lost. To the exquisite frustration of not being able to save everyone. To — at the outset of the pandemic at least — operating in a world ahead of the facts, ahead of treatments. Of not knowing. Of decisions made and regretted.
If we don’t, the work of the future — the reopenings, the ball games, the get-togethers, the restaurant meals — will be damaged, crippled by the pent-up emotion. Like the workshop 20 years before.
That workshop? Went fine after the emotional release, thanks. It’s this time around that worries me.