Star Wars: The Force Awakens. Hospitalist Edition

I have won as a father.

Star_Wars_The_Force_Awakens

Source: starwars.wikia.com

My daughters are enamored with Star Wars.

It’s a simple victory to watch my children appreciate some of the same movies and music that I grew up loving. I can’t whip my nae nae or understand the obsession with Minecraft, but I will smile deeply when they hum Yellow Submarine, Piano Man, or cheer for Gene Wilder’s Willy Wonka (outclassed Depp’s version by 100 golden tickets).

Their behavior will be short lived, and they will purposefully distance themselves from anything my wife and I enjoy in a few short years. For now, they are enjoying Darth Vader, Han Solo, and Leia as we all learn about Kylo Ren, Rey, and the latest droid BB-8.

www.bigbadtoystore.com

Source: www.bigbadtoystore.com

Unless you’ve been living in a different galaxy, you know the 7th Star Wars movie is coming December 18th. You may have already bought tickets. And you can’t walk in a store aisle without being flooded by Star Wars merchandise ranging from Darth Vader toast, to Revlon Star Wars make up, to Millennium Falcons that can fly, be used as speakers, or pass as a pillow.

The original movies’ essence came from ancient mythology, and alongside Batman, Supergirl, or The Flash, these are our modern gods and goddesses and their myths.

George Lucas clearly read Joseph Campbell, and befriended him after Star Wars was a hit. Campbell’s hero’s journey is the outline for Luke Skywalker. His path can be overlaid in many ancient journeys, as Jason searching for the golden fleece, or Dante on his journey through hell and back, with Obi-Wan as his Virgil.

Campbell describes the steps as consistent across time and space embedded in many cultural myths.
• The hero born to sparse beginnings, unaware of his noble ancestry (Luke unaware he’s brother to a princess, raised by an uncle with meager beginnings).
• The hero faces many challenges along the way (AT-ATs, Hoth deep freeze, temptation to the Dark Side, and an amputation at the hands of his father).
• A team aids him on the mission (Han Solo, Leia, droids: become the rag tag team saving the universe).
• The hero is guided with several important mentors (Do or do not, there is no try).
• Finally, a unifying mystical element guiding the way (in this case the Force).

We are all on journeys, trying to keep one foot in front of the other. Maybe not all with royal lineage, but as physicians, we have a heady ancestry, descendants of Hippocrates, Galen, Osler, and Stead. Our lives as healthcare providers, particularly our medical training, transform us into healers. During this time we fend off obstacles and seek helpful mentors, all in search of the ultimate chalice: high quality patient care.

At times, our path lures us to the dark side with burnout, unprofessionalism, depression, or worse. Yet, there is a unifying entity along our journey as well, if we want this adventure to be meaningful, noble, and altruistic. And that force is compassion.

Compassion.

It’s the motivator for physician care, for professionalism, for quality care, for engagement, and ultimately for happiness.

Medical school is a microcosm of Luke’s adventure, life’s adventure. Verghese states medical school is unfortunately not preclinical years and the clinical years, but better known as the precynical and the cynical years. Empathy appears to decline during medical school, with rotations that mimic the feeling that you are in a rebel garbage incinerator.

I distanced myself from several friends during my 3rd year surgical rotation. I was lured to the dark side by 5am rounding, a surgical attending yelling at me during operations, and endless belittling and little mentoring. I didn’t know it shouldn’t be like that, I didn’t know how to speak up, and I took that behavior and modeled it, yelling at my colleagues and my closest friend. When he showed up late to rounds, creating more work for me, I let him have it.

Many challenges await after training. For example, balancing work and life alongside a week of night call, or critically ill patients and administrative responsibilities. Difficult patients, bedside vigils, at times it all seems to be overwhelming, it all can drive one to overreact.

The 3am admissions for nonsensical complaints begin to feel like the world is fighting against you personally, and I’ve been caught looking at my 15th overnight admission, in the early ER hours, as though it was their fault they are being admitted. Really, you’ve had five months of left arm tingling and you chose to come now, in the middle of the night, when I’m on call? My body language betrays me, and the patient catches me displaying looks of impatience, a roll of the eyes, and a cursory exam.

But there is something that gets me out of that, and keeps me out of that state of mind, and that is our unifying force in medicine: compassion. The source of that compassion is internal, but aided by many other factors. As I reconcile the journey, the noble errand of compassionate care, I discover a variety of solutions. I find my team to help me instead of a source of complaints. I seek out the aphorisms and wisdom of our medical ancestors. The right mentors guide me along, and when they are not as readily available, I find myself sinking into the Dagobah swamps.

I’m looking forward to the next adventure in Star Wars. It may be just a sci-fi spaghetti western, providing escape to a time long ago and far away. Maybe I’m being a bit heavy handed, overplaying my metaphor, but compassion is what brought us into medicine, and it’s what keeps us coming back to work every day. Compassion is what ensures we fight to open our hearts to our patients, our colleagues, to the uninsured, to the homeless, to the difficult patient.

The Star Wars stories resonant because they are our stories, and they’ve been echoing throughout history for thousands of years.

The real journey is within. It’s recognizing that you are that journey, that you are part of a grand story bigger than yourself, and for a noble cause, and hope that good triumphs over evil, compassion outlasts cynicism, empathy beats back callousness, teamwork over individualism, and patient before all.

Donabedian, one of our quality improvement forefathers, the son of refugees and himself a refugee, said that “the secret of quality is love.”

Use the Force: the Force of Love and the Force of Compassion for what you do, and you will succeed on your journey.

May the Force Be with You.

Jordan Messler

Jordan is a hospitalist at Morton Plant Hospitalists in Clearwater, Florida. He currently chairs SHM’s Quality and Patient Safety Committee. In addition, he’s been active in several SHM mentoring programs, most recently with Project BOOST and Glycemic Control. He went to medical school at University of South Florida, in Tampa, and completed his residency at Emory University.

He recognizes the challenges of working in a hospital that lines the intracostal waterways of a spring break mecca. Requests that if you want to be selected as a mentored site, you will have a similar location with palm trees and coastline nearby. He tries to find time to sit on the beach with his family to escape the hospital’s miasma. While there, he looks forward to reading about the history of hospitals/medicine, and how it relates to quality (Anti-UpToDate reading material). But inevitably will get a five year old dumping sand on him, and then has to explain why she is buried up to her neck.

3 Comments

  1. Tracy Cardin on December 1, 2015 at 6:40 pm

    Jordan, I love your post and everything it says. I just wish I would have read it earlier in the day today when I really needed it!

    • Jordan Messler Jordan Messler on December 3, 2015 at 5:24 pm

      Thanks, Tracy! I guess you’ll have to re-read it every morning! Stay your compassionate self.

  2. Judith Rae on December 7, 2015 at 11:14 pm

    I look forward to reading your posts. They each are so current on life and relates so well to all professions of caring and working with people.
    And of course the writing is well done.

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