MEDPAGETODAY posted a podcast discussion between Drs. Andrew Perry and Caroline Kahle in which the two addressed the issue of “ethically-challenging cases.” * As one who never had to resuscitate a person, I was caught up by the ethical dilemma doctors face when a person suffering from a terminal illness or multiple medical issues suffers cardiac arrest.
The stories related by Dr. Kahle are every bit as dramatic as any TV hospital episode, but I think one of her points crosses over into everyone’s life. She says, “First and foremost, I think that almost every physician goes into this [profession] with empathy and somehow along the way we lose that…Sometimes it’s the job that takes it out of us, the moral injury of what we get exposed to [italics mine].”
In a conversation with a young nursing student a few weeks ago, I heard the simple statement, “People die in the hospital,” a comment made with teary eyes. Yes, the young woman was filled with empathy upon witnessing a death. So, I mentioned this to an older nurse, who with dry eyes said, “It takes a little time to get used to.”
Ambulance drivers, EMTs, doctors and nurses, police, and soldiers: All of them probably suffer from “the moral injury” to which they are exposed, to use Dr. Kahle’s words. The hardened heart, the heart that stops beating for others, is a part of human experience. We all go through that kind of cardiac arrest to some extent. And once we suffer such an attack on the heart, it’s difficult, if not impossible, for us to resume life as it was, to see tragedy as we once saw it.
I’m reminded of a line in “A Refusal to Mourn the Death, by Fire, of a Child in London” by Dylan Thomas: “After the first death, there is no other.” I think of that line when I hear a Dr. Kahle or a young nursing student recognize that human empathy can be injured, can be overwhelmed by tragedy. I think of it when I remember the death of a friend of mine when we were in eighth grade. Yes, every death since then has touched me, but no death touched me as much as the first one. I have not, all these decades later, forgotten Joe Debich who died from leukemia long before there was effective medicine for the disease. In a sense, after Joe’s death, there was no other.
Dr. Kahle calls the deadening of the heart a moral injury. It is, in fact, an empathy injury. To some extent all of us have been injured by a world that continues to add tragedies to our memories. For the most part, we “get used to it,” don’t we? But every so often, say at the conclusion of a sad movie, the empathy wells up as tears roll down, strangely for a fictional character played by actors we don’t personally know. That expression of empathy gives us hope that some measure of resuscitation works for a deadened heart.
*https://www.medpagetoday.com/blogs/ap-cardiology/80279?xid=nl_mpt_DHE_2019-06-07&eun=g1239050d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202019-06-07&utm_term=NL_Daily_DHE_Active Accessed June 7, 2019.
The stories related by Dr. Kahle are every bit as dramatic as any TV hospital episode, but I think one of her points crosses over into everyone’s life. She says, “First and foremost, I think that almost every physician goes into this [profession] with empathy and somehow along the way we lose that…Sometimes it’s the job that takes it out of us, the moral injury of what we get exposed to [italics mine].”
In a conversation with a young nursing student a few weeks ago, I heard the simple statement, “People die in the hospital,” a comment made with teary eyes. Yes, the young woman was filled with empathy upon witnessing a death. So, I mentioned this to an older nurse, who with dry eyes said, “It takes a little time to get used to.”
Ambulance drivers, EMTs, doctors and nurses, police, and soldiers: All of them probably suffer from “the moral injury” to which they are exposed, to use Dr. Kahle’s words. The hardened heart, the heart that stops beating for others, is a part of human experience. We all go through that kind of cardiac arrest to some extent. And once we suffer such an attack on the heart, it’s difficult, if not impossible, for us to resume life as it was, to see tragedy as we once saw it.
I’m reminded of a line in “A Refusal to Mourn the Death, by Fire, of a Child in London” by Dylan Thomas: “After the first death, there is no other.” I think of that line when I hear a Dr. Kahle or a young nursing student recognize that human empathy can be injured, can be overwhelmed by tragedy. I think of it when I remember the death of a friend of mine when we were in eighth grade. Yes, every death since then has touched me, but no death touched me as much as the first one. I have not, all these decades later, forgotten Joe Debich who died from leukemia long before there was effective medicine for the disease. In a sense, after Joe’s death, there was no other.
Dr. Kahle calls the deadening of the heart a moral injury. It is, in fact, an empathy injury. To some extent all of us have been injured by a world that continues to add tragedies to our memories. For the most part, we “get used to it,” don’t we? But every so often, say at the conclusion of a sad movie, the empathy wells up as tears roll down, strangely for a fictional character played by actors we don’t personally know. That expression of empathy gives us hope that some measure of resuscitation works for a deadened heart.
*https://www.medpagetoday.com/blogs/ap-cardiology/80279?xid=nl_mpt_DHE_2019-06-07&eun=g1239050d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202019-06-07&utm_term=NL_Daily_DHE_Active Accessed June 7, 2019.
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