Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

I thank my father for the gift of freeze-frame

Maureen Hirthler, MD
Physician
May 9, 2016
Share
Tweet
Share

I settle into the bent-wicker chair on my lanai and try to relax. It’s a perfect island day, the temperature warm, the breeze cool, and I gaze out over the pool to the tops of the coastal mangroves. I’ve just come home from a shift at the local free clinic, and my mind is occupied by the work we did today.  My fourth-year medical students encountered some difficult patients, and we struggled to get them the care they needed. In particular, I spent twenty minutes talking down an angry man with suicidal and homicidal ideation, and as I sink deeper into the fluffy tropical print cushions, I am wondering why I was not afraid. I would have been years ago, I think. I should have been today.

My mind buzzes with minutia. The dog needs a bath. The sheets and towels need washing. I must get to the grocery store. I have two stories I should write. I should go walk on the beach. As a pelican soars overhead, I say to my mind: freeze-frame.

freeze-frame n.

  1. A still image in a cinematic work made by showing a series of identical frames or by stopping a film or video at one desired frame, usually representing the suspension of action or time.
  2. A vivid, motionless scene or image.

I began saying this phrase to myself during the last year I had with my father. I would be someplace with him — a ballgame, the pool, a restaurant — and I would realize that we were nearing the end of our time together. I would be overwhelmed with the thought of my life without him. “Freeze-frame” was a way to deal with all the emotion that I felt. I would clear my mind and simply experience that moment, savoring everything about it, embedding it my memory. The breeze on my face. The smooth feel of my father’s wrinkled skin where I touched his arm. The way he breathed while he slept in the sun. I pushed out my fear of his death and focused only on him; I stopped time, if only for an instant.

I found myself doing the same thing today in the clinic. My student told me about his patient, a man with multiple problems and no resources to deal with them. He was unemployed, homeless, and in pain. We tried to gather medical information about this man by looking through old records; all of his problems seemed chronic and unsolvable. Why was he here at the medical clinic?

“He’s so angry,” said the student uncomfortably. “He’s saying some concerning things, and I don’t know what to do.”

“Well, let’s go see him,” I say. “I’ll think of something.”

We return to the room, and I pull up a stool at eye level with the patient and sit close, touching his arm. This is not my usual approach, but the man is clearly in distress. My student is leaning against the sink, wide-eyed at my physical nearness to this dangerous man. He is indeed angry, cursing his life, the system, society, and everyone in it. Responsibility is pushing in on me: for my safety, the student’s education, the patient’s mental health. I want to run away, leave the room, call the cops, do what I had always done in the ER, but I don’t.  I freeze the frame.

I concentrate on the other two people in the cramped exam room. The patient, whose problems are both real and overwhelming, and my student, who needs to see compassion and empathy modeled in my approach. I must show him how to care for the unlikeable, the dangerous, the other. At the same time, I need to assess the level of threat this man poses for us and for our clinic. For a moment, I can place all these thoughts aside and listen.

The man tells me his story, and I offer no excuses, no explanations for what has happened to him. I don’t judge the validity of what he tells me. I sympathize, I confirm, I encourage. At first, he is still angry, threatening to jump off a bridge or shoot the next person who annoys him. But gradually, quietly, we have a conversation. I am able to ask him about his statements, and come to an understanding of what his intentions might be. And I see a way out of this situation as he gradually looks me in the eye.

“Will you do me a favor?” I ask. The man looks startled, but nods. We then begin to negotiate details of a visit to the local walk-in mental health clinic. At first, he is adamant in his refusal, but eventually agrees some help with the stress and anger might be beneficial. He promises to come back in a week and let me know how he is doing. I tell him that even if I can’t help with his problems, I can still care about him. And I do, in this moment of frozen time. Earlier in my career, under other circumstances, I didn’t have this ability to conjure mindfulness in the midst of chaos, to freeze-frame an encounter, to exist outside myself.

Later, after the man has gone, my student says, “He really opened up to you. He was a lot less scary.” We focus on the “doctoring,” talking about safety and never being alone in the room, how to inquire about suicidal and homicidal ideation, when to quit and when to persevere. The student saw a way to take an unpleasant situation and prevent it from deteriorating to the point where all therapeutic value is lost. And I learned something vital about myself: how to work through my own fear.

At home now, I freeze another frame. I savor the salty air, the warm sun on my forearm, my beautiful home. Great white egrets and parakeets fly past. The water sparkles. I let my responsibilities fade from thought. I did a good thing today, and I thank my father for the gift of freeze-frame, through which I can find peace.

ADVERTISEMENT

Maureen Hirthler is an emergency physician. 

Image credit: Shutterstock.com

Prev

This pediatrician learned why it's so important to listen to a parent

May 8, 2016 Kevin 0
…
Next

To make big heath care changes, think small

May 9, 2016 Kevin 4
…

Tagged as: Emergency Medicine, Psychiatry

Post navigation

< Previous Post
This pediatrician learned why it's so important to listen to a parent
Next Post >
To make big heath care changes, think small

ADVERTISEMENT

More by Maureen Hirthler, MD

  • a desk with keyboard and ipad with the kevinmd logo

    I inwardly watch my life’s blood flow away. And no one notices.

    Maureen Hirthler, MD

Related Posts

  • A physician’s addiction to social media

    Amanda Xi, MD
  • What my father taught me about language

    Sarah Fashakin
  • There’s no textbook for when your father is dying

    Jeremy Pivor
  • A father and grandfather: A patient’s life lived in full

    Ton La, Jr., MD, JD
  • How a physician keynote can highlight your conference

    Kevin Pho, MD
  • Chasing numbers contributes to physician burnout

    DrizzleMD

More in Physician

  • Life’s detours may be blessings in disguise

    Osmund Agbo, MD
  • Inside the heart of internal medicine: Why we stay

    Ryan Nadelson, MD
  • The quiet grief behind hospital walls

    Aaron Grubner, MD
  • a desk with keyboard and ipad with the kevinmd logo

    How to advance workforce development through research mentorship and evidence-based management

    Olumuyiwa Bamgbade, MD
  • The truth about perfection and identity in health care

    Ryan Nadelson, MD
  • Civil discourse as a leadership competency: the case for curiosity in medicine

    All Levels Leadership
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • FDA delays could end vital treatment for rare disease patients

      GJ van Londen, MD | Meds
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Life’s detours may be blessings in disguise

      Osmund Agbo, MD | Physician
    • Inside the heart of internal medicine: Why we stay

      Ryan Nadelson, MD | Physician
    • The quiet grief behind hospital walls

      Aaron Grubner, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • Bundled payments in Medicare: Will fixed pricing reshape surgery costs?

      AMA Committee on Economics and Quality in Medicine, Medical Student Section | Policy
    • How Project ECHO is fighting physician isolation and transforming medical education [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • FDA delays could end vital treatment for rare disease patients

      GJ van Londen, MD | Meds
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Life’s detours may be blessings in disguise

      Osmund Agbo, MD | Physician
    • Inside the heart of internal medicine: Why we stay

      Ryan Nadelson, MD | Physician
    • The quiet grief behind hospital walls

      Aaron Grubner, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • Bundled payments in Medicare: Will fixed pricing reshape surgery costs?

      AMA Committee on Economics and Quality in Medicine, Medical Student Section | Policy
    • How Project ECHO is fighting physician isolation and transforming medical education [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

I thank my father for the gift of freeze-frame
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...