What if We Were Friends?

Upon returning from my frequent short-term surgical mission experiences, I am commonly asked, “How was your trip??”  A frequent response is usually…”It was overwhelming….” A sentiment used to describe the feelings of encountering hundreds of patients, some in the most desperate situations imaginable, some so far beyond help by basic medical care that it breaks your heart. The feeling of trying to safely perform surgery or anesthesia in a building with extremely limited equipment, medications, and most importantly, limited time is one of the most stressful situations I’ve encountered.

Having just returned from 2 weeks in rural western Kenya, where our team safely performed 62 surgical procedures and saw upwards of 475 patients in 4 clinical days, “overwhelmed” is a reasonable description of my current emotional state. Thinking back on the incredible levels of stress and exhaustion we all endured, I’m even more amazed by the scope and quality of work we were able to accomplish.

Within a few short days of returning, I found myself digging through a backlogged email inbox, EMR inbasket, and life in general.  Among my favorites were the administrative email noting that I had one week in which to complete my “respiratory fit testing” or my hospital privileges would be revoked, as well as a reminder of a delinquency for the annual online HIPAA training module.  As I spent my post-call Sunday staring at this inane list of required tasks, I once again felt…you guessed it….overwhelmed. But something was different this time. Even after completing all of the items on said “to-do” list, I felt exhausted but empty. What was different? I still finished a large amount of work in a very short time period.

We work in a world where the solution to physician burnout is to provide us mandatory training sessions on recognizing burnout.  Jobs are created for other people simply to tell us how to do our jobs.  I would imagine most of you reading this have seen the dreaded chart showing the explosive growth of administrators in recent years coupled with the comparatively tiny increase in physicians.  I’ve spent a few days reflecting on why the overwhelming work I encountered in Kenya was so much more fulfilling than a good portion of the work I do on a daily basis.

The team I worked with on this most recent trip to Kenya was assembled from all across the United States, with few members of the group knowing anyone else prior to our assembly in Nairobi.  In the course of 8 “short” hours crammed into vans and traveling down bumpy roads across the Great Rift Valley, we all got to know each other and some of the anxiety regarding the upcoming clinical experience began to dissipate.  The following day, we began our work.  24 strangers came together and almost seamlessly worked to provide phenomenal care for patients in dire need of health care.  The feeling at the end of each day was exhaustion, but not exasperation. The work was done, without complaint or coercion, simply because it needed to be done.  We came together, working for a common goal, and let that guide us.  Everyone stayed late, everyone checked in on one another, and NO ONE uttered the phrase “that’s not my job.” The spirit of camaraderie and dedication was enough to remind each of us why we went into health CARE in the first place.  I miss that feeling today.  I miss my Kenyan team, my group of strangers that became more than colleagues, and I find myself quoting my anesthetist friend Mohammad (from his TED talk of the same name), on a daily basis…..”What if we were friends?”  What if the motivation, resilience, and dedication we put forth in this team became our daily mantra?  What difference could we make for our patients? Our colleagues?? And most importantly, ourselves????