The saying goes, 'The sage rests, truly rests, and is at ease.' This manifests in calmness and detachment, so that worries and distress cannot affect him, nothing unpleasant can disturb him, his Virtue is complete, and his spirit is not stirred up.
Zhuangzi
Years ago, I worked in various emergency rooms around the country. That was my first ‘adult’ full-time job. It was quite an initiation into ‘real life’ for a young person. There were things I witnessed that changed how I view the world and humanity permanently. Over the years, I have tried every imaginable way to understand it, and finally concluded that that is a fool’s errand. My time is better spent understanding myself so that I might grow, progress as a human being, and, when possible, be of service.
I used to believe that emergency medicine was the most honest and altruistic form of medicine there was. When I worked in that environment, I knew some very fine people with hearts of gold and a genuine love for humanity. We are talking serious dedication! But that was over 30 years ago.
I think things are quite different from what I remember, or maybe back then I didn’t notice the incongruity quite as much as I do now. After my experience 4 years ago, I have serious doubts now that the emergency medicine I remember in any way bears a resemblance to what we have now.
Back then, I observed that there were three kinds of people who worked in the ER. There were the ‘overly empathetic’ burnouts, the ‘heart of stone’ burnouts. And those who ‘walked the line’ and somehow seemed to escape burnout. The first two didn’t last long- in those days, at least.
The overly empathetic burnouts, of which I was one, would go on to suffer debilitating anxiety, as they internalized the suffering of others, thus becoming traumatized themselves. They generally came from dysfunctional backgrounds where they were assigned the role of peacemaker and given the responsibility of ensuring that everyone else in their family of origin had their needs met at the expense of their own. These people could not have healthy boundaries and assert themselves. They found themselves gravitating towards troubled scenarios in their adult lives, and addicted to the drama of others because that is all they had known. Allopathic medicine, for the most part, was and is a comfortable fit for these folks, until it’s not. They’d find themselves switching careers at some point, or worst case scenario, become ill themselves. Likely both.
The ‘heart of stone burnouts’ were known to project all their anger, bitterness, and frustration onto patients as a mode of dealing with their unaddressed trauma. It was easier for them to dehumanize patients rather than attempt to relate to them. The ‘heart of stone’ burnouts would fly under the radar until patients complained and would occasionally be ousted by the administration at some point for bad PR. Given what we have witnessed in the last 5 years, I am guessing that isn’t happening as much anymore. I experienced many of these folks during my 13-day COVID hospitalization in 2021, and they seem to outnumber the 1st and 3rd categories. These folks frequently come from similar backgrounds as the overly empathetic, only the pendulum seemed to swing disturbingly, and pathologically, the other way. They keep their hearts tightly sealed shut and resent anyone who seems weak or weakened. It is much easier and safer than having compassion and seeing others as human.
I don’t like it, but I get it. Self-preservation is understandably human, given our fear-based programming, but it would be a tremendous service to mankind to self-assess prior to entering such an occupation, but I digress.
The third category are those that are successfully able to ‘walk the line’, meaning they maintain some sort of healthy detachment yet remain compassionate and open-hearted. This is ‘the middle way’ and represents the highest of human potential. These folks are typically in it for the long haul. They have somehow developed an ability to detach enough to do their jobs, yet maintain enough compassion to care for and deliver treatment in a respectful, honorable, and supportive manner. 30 years ago, I met and deeply admired these individuals. Today, sadly, it seems, they are rare.
I don’t feel like this is unique to the medical field. These three archetypes seem to show up in every walk of life. And there are, of course, various iterations of all three. I believe I had a front row seat, in a rather charged and amplified manner, to see this play out, and it has served to help me identify, integrate, and heal so much in my own life.
To maintain compassion, but do so in a detached way, has never been so crucial to mental health, given the times we find ourselves in. It is, in effect, the proverbial ‘put on your mask before putting on your neighbors’ advice. It’s very dangerous to over-identify with another’s pain to the degree that you lose yourself in their suffering and become inert or unskillful, or even cruel, dehumanizing others rather than allow yourself to identify with the suffering of another. There is a balance to be maintained.
I suppose that is my message. Do you have an open heart? If so, is it so open that you have become injurious to yourself, thus incapable of being fully supportive of another? Or have you closed your heart? Do you now regard the suffering of the other as not worthy of your concern?
It is not easy. I recognize that. But, given the state of our world, I see this as a worthy inquiry and truly crucial to our evolution as a species.
Walk the line.
Many blessings to you!
April
Thank you for sharing! 😊