An incredibly strong, sobering metaphor was made today at Arlington National Cemetery. The notion that 400,000 lives lost over the course of several wars in the pursuit to protect the freedom of citizens to pursue meaningful goals matches the loss of those citizen life every year due to medical error is disheartening and baffling. It hits home because just as each member in this cemetery belongs to a family…leaves behind loved ones… each patient who loses his or her life does too. So it is sobering, but Arlington holds another impactful metaphor that offers hope to the medical discipline. That is a metaphor that can be found in the ritual of the Changing of the Guard.
The Changing of the Guard has a long, rich history which each sentinel imbues and lives through his duty. The process by which a soldier might become a sentinel can be likened to the path of a medical professional. Several steps over many years, prerequisites of precision and wrote knowledge, strict guidelines by which to adhere, and a trial-phase through which they are inducted all mirror the path of a physician as well as many others. It is a process by which the elite are molded and trained to follow protocol and demonstrate respect in honor of the lives lost who will never be named or known.
Medicine is a similar process, but the respect and honor of life sometimes falls short. Perfection is nigh impossible. Precision teamwork day-in and day-out eludes us. But why? Is it just the human condition or something more? We have a just cause in a profession to which one is self-selected. Medical professionals dedicate their lives in a noble pursuit just as the sentinels do, so perhaps there are more lessons to glean from these teams. The lessons are not only in the precision of their work but the driving force behind it – the reminder of the cause. They are not allowed to forget; their consistent pre and post shift time-out offers and demands that much. The mindset toward such a task should therefore be, “this is a gift that gives us a chance to regroup and get ourselves on track” rather than “this is a nuisance protocol through which we must rush due to time constraints”. Understanding the purpose of these checks, the value of teamwork and a common language, the power of the interdisciplinary make-up – these are the lessons of which such a ritual can remind us. Each move we make is out of respect for the life of the patient just as the sentinels’ is for the loss of the unknown who dedicated their lives to protect the freedom to become the professionals we are today and will be in the future.