“There will always be suffering. It flows through life like water …”

Those famous lyrics sung by Nick Cave in his Lime-Tree Arbour ring true for many of us. They take on an entirely different layer of meaning for physicians.

Even the very journey of becoming a physician is marked by suffering. While many of our classmates frequented football games, nightclubs, and social events, most of us were studying day and night to make sure we had the competitive GPA and MCAT scores to even make it to medical school. Most of us remember the fire hydrant of information that flew through us those first couple of years of medical school, followed by sleepless nights on many rotations during our third and fourth years. The fight did not end there, however. Internship and residency brought on the grueling years of training that tested our physiology and mental stamina, built resiliency and sometimes even made us question whether we had made the right decision to choose this profession. Most of us kept going though, simply because we were following a higher calling, something beyond our immediate struggles and challenges. We had a vision for ourselves, our patients and our future.

How does suffering affect us? How does it change us? What can we learn from it? How can we make sense of it and continue to do what we do every day?

Fyodor Dostoevsky, in his book, Notes From Underground writes, “We can truly love only with suffering and through suffering!”

Perhaps it is inherently because of the way we, human beings are created. We often fail to appreciate what is ever present, ubiquitous and easily given to us. We appreciate things and people more in their absence. We appreciate health, when we are stripped of it. We appreciate our loved ones more after they are gone.

Is there value in suffering? What can we learn from it?

Suffering and pain teach us about our imperfect nature and how fragile we are. They teach us about the fleeting nature of life itself. We, physicians, come in contact with death perhaps more than any other professional. We lose patients to illness on a regular basis and go through the exercise of loss often. It doesn’t get easier to lose, but it does help us better understand the value of human life and time itself.

Perhaps the most valuable “gift” that suffering leaves in its tracks is imparting greater wisdom, empathy, and compassion to the one who suffers. It allows us to grow in resiliency, tenacity, understanding and greater insight into the world of those who suffer. Most patients would agree that while expert knowledge is critical to the quality of a physician, so is her ability to empathize and listen compassionately. This is why we are not simply scientists. We are physicians — those who are skilled in the art of healing.

In our new era of Healthcare 2.0 where we are required to use the hundreds of clicks and buttons for the electronic medical records, it is easy to forget to look the patient in the eye, to slow down, pause and be silent and present with the patient. The modern practice of medicine has put more time and documentation limitations on physicians than ever before.

However, this is where we have to put the computer aside for a moment, look the patient in the eye and truly listen to their stories. It takes practice to learn to do this. But more importantly, it takes facing our own humility and what it means to be a human being to allow ourselves to slow down and just be present with another human being. This is the sacred part of medicine that no computer, no administrator, no business organization and no insurance company can ever take away from our profession. This is the sacred part of medicine that every patient longs for when they walk into our offices, and we owe to them as people to give them the gift of listening with all our hearts, minds and spirits. We owe this to them because only then we can truly understand and empathize with their suffering and have an opportunity to start the healing process. This is the magic of medicine that is so inspiring. I had an attending once who said, “Patients give me more than I am ever able to give them.” I was only a medical student then and did not understand the depth of his statement. Now I do. I am eternally thankful and blessed to have the privilege to serve as a physician. They have inspired me, humbled me and taught me some of the most important lessons in life.

I wrote this poem in 2009 as a dedication to my numerous patients, who gave me such gifts.

Of dreams of life and rain

The light was off,
no sound was heard
and there he lay
in his still, dark room
how many cheeks
had he kissed and loved
how many steps
had he ran, not walked

how many hands
held his hands that lay
wrinkled, gray and frail
against the white sheets of clay

Did he want to live
yet another day
with no visitors
only memories
did he pray for life
or recovery
or a sound sleep
with no awakening

Did he dream of times
when he soared in life
with the eagle’s dreams
and the wind of time

Did he want to live
yet another day
or to fall asleep to
dreams of life and rain.

Kristine Tatosyan-Jones is a family physician.

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