Compassion and compartmentalisation

I REMEMBER the first time I saw a cadaver, I was more disturbed by how undisturbed I was than by the cadaver itself. I’d expected to feel faint or sick. But it just looked like a leg. And an arm. I had those. A thought intruded: What if I get used to death?

Sometimes I worry that, when it comes to medicine, I might be too empathetic for my own good. I cried just listening to our obstetrics lecturer tell a moving story about a seriously ill woman whose greatest wish was to have a child, despite the risk it posed to her life (she had two beautiful girls but died as a result of the second birth).

Compartmentalisation. The word sounds like a challenge to me. If I’m so easily affected by relationships between women and children, am I risking my own wellbeing by pursuing obstetrics as a specialty? Could I potentially watch a patient die and then just put it aside and keep working? Could I bear unbearable news to their loved ones, then go home to my own family untouched? Could I work with children, see mothers devastated, and then have kids of my own without that playing on my mind?

It comes down to a battle between compassion and compartmentalisation. Without the former, we cannot and should not practice medicine. But how can we have a life outside of medicine without the latter? As a second-year medical student, I can only hope the two are not mutually exclusive, that there is a way to balance mental health and workload with the emotional toll of caring about difficult things. Medical students like myself come up short of an answer and receive mixed messages from those who have been through the wringer themselves.

Studying medicine has been a blessing for me, endlessly interesting and full of amazing opportunities to get involved in global health and humanitarian work that I had never anticipated. I worry though – and I am not alone in this concern – that in the exhaustion of my medical training that once I graduate I will lose touch with the passion and compassion that drove me towards medicine in the first place. The prospect of balancing work and a future family life is daunting in itself, let alone having time to pursue humanitarian work on the side. Forget passion outside of the hospital, will I even have time for it with my day-to-day patients?

I will never forget the words of an emergency neonatal specialist who told my friends and I that the death of a baby under her care still keeps her up at night, even after decades of work – and if it wasn’t keeping her up at night, then she would have to quit. Perhaps the only solution is to face the burden of caring head-on, to accept suffering as a necessary condition of empathy. It’s a struggle against apathy that we face even in the smallest of ways, along with the rest of the population, scrolling past troubling news of airstrikes in Syria. I believe we can allow the pain of compassion to touch our hearts without breaking them. I hope I don’t look at patients and see a form to be filled, or another hour of sleep lost. I pray that the loves and losses of my patients mean something to me, bring a tear to my eye if not a full stream.

It’s a problem with the system, but it is also a matter of keeping ourselves in check as medical professionals, remembering what our values are. I hope that, in the midst of the chaos of training and late-night shifts and hours of paperwork, I never forget that I am dealing with whole, thinking, feeling people who have loved ones and ambitions and fears just like me.