Silence was palpable and she filled the air with a thickness that promised to suffocate her victims. A young Man timidly stepped forward. As his feet hit the ground, the reverberation seemed to violate the Silence, threatening to crystalize the air, each step tormenting with its intensity. The Man wished to speak, but the Silence promised only to prolong the torment.
With each step, the Man’s coat swirled around his legs like a superhero’s cape, belying his internal conflict. Silence simply would not allow such delusions of grandeur. What more could the Man say? What more could he do? His heart weighed heavy with the guilt that, perhaps, he could fight back the Silence with words of Hope.
Hope, however, was not there. He refused to respond to the Man’s beckoning and like water, could only trickle through his outstretched hands and crash onto the floor, frozen over in the mere presence of the Silence. The Man’s words were lies and, like spears of ice in the presence of the Silence, would only pierce through the veil that clung over the Man, reminding the victims of their shared torment. In the shadows, the Witness stared blankly into his hands, ignoring all present – the Silence, the Man, and, especially Hope.
As the Man stared blankly into the Woman’s blank face, hands placed upon her protuberant abdomen, he knew the Silence would win. Lost in the deep recesses of his self loathing, he was nearly immune to the soft weight on his shoulder.
The Witness spoke and Silence immediately took notice. The Man was momentarily pulled from his abyss as he stared up at the Witness, dazed by the audacity of the simple words.
The words underscored the cacophony of emotions swirling within the Man’s head and landed with a loud thud in the presence of the Silence, shattering the pretense of grandiosity like an anvil thrown into a crystalline lake. The Man fell through the ice, bathed by the proverbial waters and his once dry globes were no longer impassive, but welcomed the Hope the Witness promised.
Looking up from his personal prison, the Man looked to his friend, the Witness, and was reminded of the firmness beneath his feet.
He knew that his friend’s wife would not make it. She would die. There was nothing that he could do to change this simple fact.
No amount of medical education could ever have prepared this young physician for this moment. How can you tell your friend that his wife would surely die? How do you tell him that his son would never know his mother the way a son should?
He would never see her at his graduation. She would never be at his wedding. She would never hold his children. She would never be able to spoil them with oatmeal cookies and cheap candies.
Years later, the Man, paralyzed in his grief, could only stare at the creases in his hands in disbelief. Who was this moron?! How could he do such a thing?! Silence knowingly nodded towards the Man and he took center stage, clasping the young Physician on the shoulder, releasing him from his personal torment.
“It’s okay. I forgive you.”
Expect Perfect; Accept Imperfection
The dichotomy of these two diametrically opposed statements seems to underscore how we tend to practice medicine. We expect perfection. Any failure is surely to be highlighted in this week’s M&M whereby we grill our colleagues until they are metaphorically seared, sometimes with nice crispy edges that seem to magically transform a conscientious caregiver into a callous bastard. On the other hand, we are constantly reminded of the necessity to “…admit our errors…” in a hollow attempt to highlight humanity in medicine.
In this vane (yes, vane and not vain) pursuit, we are constantly told one thing (accept imperfection) but find ourselves being ostracized when we fail (expect perfection). It is the simple act of offering forgiveness that seems to offer some consolation, and we as a whole, must be willing and ready to offer that forgiveness. We must be ready to admit our faults and be willing to offer forgiveness. It was in my lowest moment as a physician that the simple act of forgiveness washed over me and saved me from my own personal torment.
“To err is human; to forgive, divine.”