New awareness

The challenge is to keep our eyes, ears and hearts open and tuned in to the incredible interactions that we encounter daily.

Did you ever have the feeling that each day was just like the one preceding it and that tomorrow will be little different? Although our days are characterized by singular events involving patients, procedures, meetings, conferences, rounds and so on, they can blend together without our ability to appreciate the variety that can lead to excitement and creativity. Perhaps this repetition (the “Ground Hog Day” phenomenon) is the ultimate reason why we need vacations to break the “sameness” that may be the basis for the stress in our lives.

In thinking about the repetitiveness of this cycle, it occurs to me that we should be challenged to ask ourselves three vital questions at the end of each day. For years I frequently challenged the medical students and surgical residents to make sure they asked themselves the question, “What new piece of information did I learn today?” Although factual knowledge about disease processes is important, perhaps this question is of secondary importance and ultimately nonsustaining. So what are the real questions?

Question 1—for reflection at the end of the day should be “What surprised me today?” When I awakened this morning, what event or experience was I not anticipating? Obviously for surgeons, the surprise may take the form of unanticipated pathology in the operating room or the unexpected challenge of a patient’s diagnosis.

The real essence of Question 1, however, is to gauge the effect of any unexpected interaction with another person, either positive or negative. Did the comment of a patient or colleague elate or disappoint us and, if so, did we incite the surprise comment or action? If we were surprised during the day, did we react appropriately and in a manner that would make us proud should we encounter the same event tomorrow, next week or next year? There are many events that are not anticipated throughout the day. Perhaps we are too distracted to remember these isolated events, but reflection at day’s end will be rewarding.

Question 2—“What moved or touched me today?” As physicians, we have great opportunities to interact in activities that are both heartwarming and heartrending. How did we feel when we talked to our patient about the maximally invasive operation that he was going to experience? Did we understand the emotion and life-changing experience of the mother with two small children when we introduced her to her breast cancer diagnosis? Did we appreciate the struggle and pain experienced by the postoperative patients who passed us in the inpatient unit as we made rounds?

Novellas could be written about the experiences and interactions that we fail to appreciate each day. The challenge is to keep our eyes, ears and hearts open and tuned in to the incredible interactions that we encounter daily. Here, some note taking at day’s end would be advantageous since even the most poignant encounters or life-changing experiences may become lost if not chronicled. At the end of a full day, we may have difficulty discerning those fleeting moments that really enhanced our day. The very act of keeping a journal and giving answers to these first two questions will give future pleasure, insight and solace as we peruse our notes and reflect on these experiences at a later date. It might be a revelation to relive those events that moved us and perhaps changed us as a human being.

That brings us to Question 3—“What inspired me today?” What did I witness that made me really appreciate my choice of a career or push me to develop a new thought, activity or even different life direction? This is really the ultimate question. This is really why I want to get up in the morning and have the desire to repeat the exercise tomorrow, next week and in years to come. Was I inspired by my work in the OR? Was I inspired by my rounds with students and residents? Was I inspired by the Grand Rounds presentation or discussion at Morbidity and Mortality Conference, and did these discussions challenge me or create a new awareness?

Yes, each day can feel repetitive and unrewarding unless we make the effort to appreciate and chronicle those special moments, thoughts and encounters. We live in a rich and complex work environment and we should make the most of it. At the end of the day, ask yourself these three questions. You will be surprised to hear the rich and rewarding answers that are forthcoming.