“Mama, Ember’s breathing funny…”
My daughter’s small but worried voice made me bolt up in bed. Ember had been breathing a little fast before bed and his lungs sounded a little coarse, but he was comfortable. Between wrapping gifts, I checked in on him several times in the night before finally collapsing in bed after the last package was wrapped.
So much for letting my guard down.
They teach you in medicine to watch out for sick kiddos. They can be hanging in, seeming just fine, and decompensate in a matter of moments.
Ember, my resilient fire-child, did just that. Hearing him audibly wheezing, tachypneic and with accessory muscle use filled me with absolute horror. Please, not my child.
It was pouring rain in the wee hours of the morning as we carefully made our way to the hospital. Looking back constantly to make sure he was still hanging in there, and hoping for safe passage on the slick roads, it felt like a bad dream that one longs to escape.
The emergency department was eerily quiet - I guess that’s how it is in the pediatric ED on Christmas Eve. Thanks to the miracle of modern medicine (aka nebs and steroids), Ember improved quickly enough that we were able to be discharged from the ED and enjoy Christmas at home together as a family.
In summary, it was a simple short-stay in the ED for presumed asthma exacerbation secondary to bronchiolitis. Bread and butter. No biggie. But it was an absolutely horrifying and stressful experience. Had this happened to one of my families I care for, would I have been able to grasp what a toll this would have taken on them, considering how much it strained me, even as someone who works in medicine?
It’s amazing how stoic and unencumbered we can feel as physicians about these everyday conditions. Carrying for a wheezing pediatric patient in my clinic generally would not throw me into a tailspin of worry like I felt that harrowing night with my own child huffing and puffing. But sometimes, certain patients will trigger us. They will remind us of something in ourselves, or our loved ones. They will pull at our heart strings, creep into our psyche in the night, and sometimes cloud our judgment. I can’t help but wonder if I will maintain my same cool the next time I’m caring for an acutely ill child with asthma.
See, the beautiful thing about doctoring is that we can bring our humanity to it. And it can deepen our work and impact in incredible ways. But it can also blur boundaries and adversely influence our decision-making.
This is the difficult balance we strike as physicians. Be humane, but strive for objectivity. Be caring, but don’t care too much. Empathize with the fact that being ill can be damn hard, but don’t overly feel your patients’ emotions and burn out.
What a fine line we walk in this doctoring game. We sure never get it just right, but I’ll lean into the humanity of my profession on the regular. And it can sometimes tax the empath in me, but it can also replete me in so many ways. So maybe I’ll worry a little more the next time a wheezy child comes through my door. But you better believe I’ll take an extra beat to comfort that worried parent, too, and we can work together to find answers and healing.
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