I knew I wanted to be a physician from the time I was five years old. I watched my mother on the phone, as she described the way my infant brother was drooling, and leaning forward (tri-poding) in his crib. I listened as the pediatrician put the seemingly vague pieces together into a diagnosis of epiglottitis. It seemed medicine was this beautiful melding of science and listening, and from that moment, it was all I ever wanted to be. I spent the next three decades of my life, following a vectored curriculum, believing I would emerge transformed and able to heal.
In medical school I fell in love with the human body, in all forms. The anatomy, the genetic code, the divine elegance of the disease states. And it continued through residency and fellowship. Medicine became my orientation and my identity. Understanding and treating diseases became my purpose.
Until the final day of my fellowship training when a tumor ruptured in my liver, and in the space of two hours I went into multisystem organ failure. My liver failed from the compression of the blood volume, my kidneys shut down from lack of blood flow, I received 26 units of packed red blood cells with additional clotting factors and the platelets of strangers. I was placed on a ventilator and a medically-induced coma.
In the operating room I heard them say, "We're losing her." I thought to myself that they were right, that if I could see myself on the table, that perhaps I was already lost. I felt very small, weightless and yet at the same time, expansive as if I were part of everything at once. The devastating pain that had brought me into the hospital was gone, and I felt oddly, completely at peace.
The baby I was seven months pregnant with would not survive that operating room, but I would, thanks to the incredible grace and skill of my medical team.
That immediate transposition, from critical care physician to dying patient made visible to me the things I hadn't been able to see. I saw things about us, physicians and other medical providers that in truth I might not have wanted to see. I saw how flawed my orientation to the diseases had been. How I had in so many ways thought of the patient, as this place where the diseases that I studied (and been enamored by) would land. How I had disarticulated myself from emotion, the way I had been instructed to in my training, so that I could remain objective and demonstrate sound medical judgement.
I entered the hospital a physician. I left, weeks and weeks later, in a wheelchair, having had a stroke from lack of blood flow to my brain, I was missing words (important words, some of my favorite words, like shoes). I was unable to put my socks on unassisted, unable to walk more than a few steps. I had to completely reimagine my identity.
That was a gift. Because in that empty space where I no longer existed, I had the opportunity to truly examine what medicine had given me, and what it didn't have to give.
Medicine had given me my life back, and at the same time it had broken me. When I heard the medical team on rounds describe me as, "trying to die on us," I saw for the first time, how our orientation towards the disease set up a dynamic in which the patient could be viewed as the opponent. When asked to hold the baby who had been dead for days, in some ritual meant to promote healing or bonding, I refused. The nurse who had offered was offended, believing that "every baby deserved to be held by their mother at least once." This logic left me baffled.
Who was she there to heal? In suggesting what I needed to do, she revealed another great flaw in our system, a thinly-veiled paternalism that persists despite best efforts to do the contrary. The nurses weren't wise enough to ask the right questions, "What might assist you in your healing? What is most difficult about this time for you?" I saw how our system, with its rigorous demands on time and productivity, didn't allow room and space and time for physicians to be fully present. And how not being able to tend to your patients' emotions, not feeling like a healer proved to be incredibly isolating for so many of my colleagues.
I had to reimagine what kind of physician I would be when I returned to medicine. I had to re-examine how I could be an instrument of healing in the way my patients actually needed me to be, rather than the heroic narrative I'd been instructed in. I found a humility there, in being present for my patients, honoring their strength, asking generous questions, learning their fears. I found reorienting myself to face the same direction as my patients, was everything.
By spending time in the dark spaces with them, I would be invited to participate in their healing process. And this would open channels of compassion and empathy that were in fact reciprocal. My patients held the answer to the question of purpose and resilience. But it wasn't where I was expecting it to be, it was in the darkness. My identity as a physician was wrapped up in illness, but not as I had believed when I was young. It was not in the diseases themselves but in the humanity of witnessing and attending to the suffering.
Rana's book, In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope, is out now.