On the Eve of a New Year

By Hedy Wald

Looking back, looking forward. It’s what we do on the eve of a new year. 24 hours away from a fresh start, resolutions, inspirations, and even some trepidations . . .  2020 sounds like science fiction and yet, here we are.

Social media is gushing with good wishes and plenty of party hat and heart emojis. @pranaysinha summed it up nicely: “Hope, love, and gratitude.” And following the Dalai Lama on Twitter can make your day; @dalailama: “I believe that if we make an effort to develop peace of mind within ourselves and cultivate a proper appreciation of the oneness of humanity, we can create a happier, more peaceful world. What we need is common sense-the positive use of intelligence-and warm-heartedness.”

So it’s not all party gaiety, it’s also serious contemplation of where we’ve been, where we are, and where we’re going. Resonates for me with the Ten Days of Repentance associated with the Jewish new year . . . reflect, look inward before looking outward – apologize, improve, be kind.

So many parallels to our vision for humanism in medicine. And for the work we do in medical education.  It’s about doing the work of a physician but it’s also about being a physician1 –how do we cultivate a prepared heart and mind for the inevitable complexities? Ethical vigilance? Values? Moral integrity and resilience? And when we close that exam door and are face-to-face, heart-to-heart with that vulnerable, suffering human being and/or family caregiver, how do we bring intentional presence2 to that sacred space with readiness to receive and hear the narrative, readiness for responsibility?

Reflective practice can help; making the active, dynamic, and constructive process of professional identity formation (PIF) explicit in the curriculum with appropriate faculty development can help.3 PIF is relational, not “delivered” and interactive reflective writing (IRW) can be effective for grappling with the lived reality of medicine as well as societal challenges.3

There’s more. How are we treating each other in the learning, clinical practice, and research environments? Can we bring the values we espouse for humanistic patient care into the workplace with colleagues and educational climate with trainees? Relationship-centered care? So relationship-centered education.4 Person-centered care? So student-centered education. Mindful practice with patients? So mindful teaching of trainees and mindful interactions with interprofessional teams. Kindness as a lifestyle with sensitivity to personal and professional narratives of those around us.

I published about this in the context of a very challenging year and a very challenging loss. Yes the personal and professional collide. Over 100 readers wrote to me (and many more on social media) about my essay “Helping my Husband Live and Die”5 which emerged like a spiritual experience one week before that beloved human being passed. “Kindness matters,” I wrote, as the unimaginable was unfolding in my life. “So does opening your head and heart to narrative. For patients and similarly, for colleagues around us who may be coping with significant stressors personally if not professionally. ‘Narrative medicine’ includes both personal and professional stories— do we have the courage to hear them with intent to help?” Standing on stage in Basel for an AMEE (Association for Medical Education in Europe) plenary while speaking on “Integrative Resilience,” I invited a full conference hall of health professions educators to consider that the words ‘How can I help?’ may be the culture change we’re looking for. Yes, the personal and professional collide. In addition to your patients, what may your colleagues and trainees be grappling with? How can you, I, we help?

I’ve been reflecting on gifts of connection in my life that help ease the pain. Family, friends, sweet people on line at the grocery store who make me laugh. About joys in teaching when students let you know you’ve made a difference. About the snail mail thank you card from occupational therapy students at the Mayo Clinic that now sits on my desk for inspiration. About unexpected gifts of time that can be transformative. I am, for example, filled with gratitude for the privilege this past year and now in the new year of working with students and faculty at the Witten-Herdecke Faculty of Health, Germany to use the history of medicine, the Holocaust and medicine, for reflecting on the becoming of a health professional and more broadly, being a human being.6  This endeavor has been an opportunity to realize the integration and application of my scholarship on IRW, PIF and this history as I facilitate reflection within their “Cultivating Medical Awareness and Ethics Through the Example of Medicine During National Socialism” course and reciprocally, experience growth of my own lifelong PIF. I now braid personal and professional narratives when discussing this topic with students and faculties across the U.S.  So relevant to contemporary medical dilemmas and societal issues of preserving human dignity.

One more reflection-inviting question. How might we shine the light on triumphs and successes in our work and in our life, when, in the words of Barbara Fredrickson, we are faced with “the positive whispers and the negative screams?” We can do this. It is, after all, the eve of a new year.

Hedy S. Wald, PhD is Clinical Professor of Family Medicine at the Warren Alpert Medical School of Brown University and Faculty, Harvard Medical School Global Pediatrics Leadership Program. She presents internationally on interactive reflective writing-enhanced reflection supporting professional identity formation, promoting resilience and wellbeing, and Holocaust and medicine in health professions education and practice.

REFERENCES

  1. Sandra Jarvis-Selinger S, Daniel D Pratt, Glenn Regehr. (2012). Competency is not enough: integrating identity formation into the medical education discourse. Academic Medicine 87(9): 1185-90.
  2. Hedy S Wald, Aviad Haramati. (2015). Hineni – I am Here: On Presence and Sacred Space. (Special section – Spirituality in Medicine – Creating Sacred Space.) Journal of Alternative and Complementary Medicine 21(6): 247-250.
  3. Hedy S Wald. (2015). Professional Identity (Trans)Formation in Health Professions Education: Reflection, Relationship, Resilience. Academic Medicine 90(6): 701-706.
  4. Michael W Rabow, Maya Newman, Rachel N Remen. (2014). Teaching in relationship: the impact on faculty of teaching “the Healer’s Art.” Teaching and Learning in Medicine 26(2): 121-8.
  5. Hedy S Wald. (2019). Helping My Husband Live and Die. Journal of the American Medical Association – Neurology 76(4):396-397.
  6. Shmuel P Reis, Paul Weindling, Hedy S Wald. (2019). The Holocaust, Medicine, and Becoming a Physician: The Crucial Role of Education. Israel Journal of Health Policy Research 8:55.

8 thoughts on “On the Eve of a New Year

  1. Excellent use of parallel process! “Can we bring the values we espouse for humanistic patient care into the workplace with colleagues and educational climate with trainees?” Our work must be patient AND learner centered, but more importantly relationship centered; relationship centeredness means that no one of us is at “the center” and helps us move beyond consumerism in patient care and beyond “patient (or learner) satisfaction” as only one measure of patient-centeredness and learner-centeredness. And thanks for bringing your personal into the professional!

    Like

  2. I appreciate your time in posting these insightful and kind comments. So glad the piece resonated with you and your fine work. Sharing our narratives can be beneficial for trainees as well – we’ve recently published on the use of faculty resilience narratives (videos) in residency education: https://www.igi-global.com/article/faculty-videos-of-resilience-narratives-at-two-institutions/245770 and using personal narrative in faculty feedback to students’ reflective writings: https://www.mededpublish.org/manuscripts/1832 Thanks for walking the talk in all you do for patients, colleagues, and learners and happy new year! All best, Hedy

    Like

  3. What a LOVELY reflection at the start of 2020. I am always in awe of how authentic, transparent openness from one (YOU) can amplify the “positive whispers” and calm the “negative screams” in others (like me)!

    Like

    • So gratifying for a writer to receive such feedback. I appreciate your time reading the piece and commenting on its impact. Positive feedback such as yours may encourage others to bring their authenticity and transparency to this space. Through this, perhaps, our deepened connection will be a ripple effect, even a wave to benefit our trainees and patients. A nice thought for the new year- thank you!

      Like

  4. When under stress long ago during my residency, I wondered how I was going to manage to continue. A physician colleague was observant enough to notice my distress from a distance. When denying a problem, she persisted. Again, I denied any issue but my body language gave me away. She then spoke five words, words that I have never forgotten. “How can I help you?” My life turned 180 degrees in an instant. Someone cared. Forty years later, we met at our Reunion. I was still working but she had chosen a new singing career a few years earlier. We recalled the earlier event. She saved me but modestly made light of it. You need people like that around you always. Your words Hedy are in the same vein. Not only patients but doctors need help too. You have likely saved a lot of folk from despairing a doctor’s life. I loved your sentiments.

    Like

    • Oh Dr. Verjee I am so moved. How beautiful and validating it is to have my words resonate in this way. A writer puts a piece out there and a reader makes it their own. How fortunate we all are that this physician colleague reached out to you and helped so you can share your gifts and talents with a broader learning and practice community all these years and coming years! Thank you for your time in sharing your thoughts and for your kindness.

      Like

  5. Your post helped me start the new year with optimism and a new groundedness. I will approach others with, “how can I help?” and ask myself the same question. As always, you inspire and motivate me. Thank you for everything.

    Like

  6. Dr. Van Deusen – you are a sensitive soul and it has been a pleasure presenting for your learning community and getting to know you and your work better. I’m mutually inspired! Such positive energy within a supportive community of practice with #kindness and #gratitude can have a ripple effect if not a wave effect for patient care as well! Hope our paths cross soon.

    Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s