A haiku and humility

patient-centered mind

fullness, apologetic

transparency; wow.

What do each of these words have in common, beyond comprising a poorly written haiku devoid of natural imagery summarizing my Telluride takeaways? Each student departs this experience to unique environments, with different lessons learned, and different plans for implementing changes to the systems they find themselves in. These words are a short list of key words and concepts that I wish to retain from my time in Napa; I was familiar with each prior to Telluride, yet each has taken on additional meaning over the last few days. While these words are united by haiku composition and status as favored patient safety subject matter, they are also united by the fact that none can be fully achieved without the practice of humility by the healthcare provider. While it’s important to implement new checklists, techniques, and communication strategies, none of these will really work unless we also make changes to ourselves. As healthcare providers, we must seek to become the sort of humble people that will enact and follow through on these changes by habit. The following is a brief summary of my rationale for including each word, written as much for myself as for the reader.

Patient-centered– A common buzzword in modern healthcare, yet less commonly practiced. One of the most powerful components of the Telluride experience was the patient/family member narratives. Having family members physically present, visibly battling emotion years after the events they are describing, makes it impossible to view the problems we are discussing as numbers on a page or points in a chart. While the hi-tech, data-driven approach of modern healthcare gives us great power to improve health, we must not detach ourselves from the human beings at the center of our profession. This requires our humility; we must put the interests of others before ourselves when we are tired, overwhelmed, and inadequate. We must not become a system operating for our own benefit.

Mindfulness– Habits, habits, habits. Often we operate as the sum of our habits. One of the most important things we can do to promote a safer healthcare environment is to habitually practice mindfulness. Incidentally mindfulness, by definition, cannot be practiced apart from habit. If we are not habitually mindful of our surroundings, mindfulness becomes a discrete action rather than a state of mind. Mindfulness requires humility as well; I must push my own needs and concerns back in my mind and embrace the events of the surrounding world. Also, the only portion of the haiku that I really like is the way that “mindfulness” has been broken by stylistic rules to create “mind” and “fullness” on two separate lines. In the interest of space I’ll leave additional literary criticism to the hordes of rhetoricians and poetry professors that I’m sure are reading the blog.

Apologetic– It’s a cheesy truism, but with great power does indeed come great responsibility. Part of our responsibility as healthcare providers is to apologize, and not to offer a mere shadow of an apology (as I used to when forced to apologize for telling my younger brother he was a poopy-face) but a full-fledged apology that not only includes a true and accurate description of what went wrong but also continued commitment and action towards repairing the broken system that led to the event. In the past, offering an apology has been a blow to my pride. It’s a public admission that I don’t have things as together as I’d like to pretend. Taking such a step requires great humility by the provider.

Transparency– Many, many problems in healthcare can be traced to a lack of transparency in the system. Patients don’t comply with treatments because providers are not transparent about the unpleasant side effects that may ensue. Hierarchy continues to debilitate communication because providers are not transparent about our weaknesses or our personal lives. Patients often don’t know where to set their expectations for their healthcare; thus, they don’t demand a safer system when things go wrong and often aren’t taken seriously even when they are making appropriate requests for additional or alternate medical attention. Like offering a true apology, it’s impossible to consistently be transparent without the practice of humility.

Wow– I’ve already written far too much, but throughout this week I have been wowed by a renewed sense of the magnitude of the task I’ve taken on as a medical student. I’m wowed by the deep and long-reaching effects my actions can have, wowed by the amount of trust and responsibility that is still granted to healthcare providers, wowed by the depth and breath of problems in the system, and wowed by the privilege of working together with energetic, thoughtful, and dedicated colleagues for decades to come as we seek to improve this great human endeavor of caring for one another. I believe that the less we are consumed by ourselves, the more opportunities we will have to be wowed by the wondrous opportunities, creations, and individuals surrounding us.