Hey Rockstars,
I was on the phone with my friend today and when I asked him, “how are you doing?” to which he said, “I’m alive,” which basically sums up how I think every single person’s week is going.
As for me, I went to the emergency room unexpectedly this week. Everything is okay, and I’m not going to delve into why I was there or who I was there for. But the fact that I spent several hours in an emergency room is important context for this post. Despite maintaining a personal blog about my inner life, I do still believe in privacy.
Who is this Random Man?
So, naturally, let’s begin with the man I tried to prevent from entering the room. At one point, I was standing near the entrance when a man I did not recognize started walking in. I gave him what I can only imagine was an extraordinarily suspicious look and, rather than moving out of his way, remained firmly planted where I was.
“It’s okay,” he said.
Okay for whom? I thought.
Perhaps my face communicated this, because he immediately added, “I’m the doctor.”
Oh. “Got it. Yes. Okay.”
And that was how I met Dr. Cole.
Fortunately for Dr. Cole, his first encounter with his self-appointed ER bouncer was not predictive of the rest of our interaction. He was patient. I asked approximately seventeen thousand questions, and he answered them without ever making me feel rushed or stupid for asking. He explained what he was thinking, what they were doing, what information they were waiting for, and what would happen next in a way that I could actually understand.
Meanwhile, I was running quality control through my best friend Divya.
Not secretly, either. At some point, I told Dr. Cole, “Not that I don’t trust you, but I’ve been texting my best friend. She’s a resident at UMD.” He immediately said that was awesome and asked what she did. “Family medicine,” I told him. “That’s awesome,” he said. He didn’t seem remotely bothered that I had another doctor on the other end of my phone asking questions about what was happening, which was fortunate because I had absolutely no intention of stopping.
The Divya Audit
Divya is one of a very small number of people I told about any of this. She is also like a sister to me and, conveniently for me in this particular circumstance, a doctor. So throughout the night, I was texting and calling her, telling her what was happening and asking her to explain things to me. She was essentially conducting her own checklist from the other end of my phone: Did they do this? Did they test this? Did they check this? Yes. Yes. And yes. Every time I answered yes, I felt a little better.
It wasn’t really that I distrusted the doctor. I just didn’t know enough to know whether I should trust him. I am accustomed to understanding the architecture underneath an answer. If someone tells me something about a legal issue, even if I don’t immediately know the answer, I generally know what questions to ask. I know what might be missing, how to research it, and know enough about the underlying system to evaluate the information I’m being given. In the emergency room, I didn’t even know what I didn’t know.
There are plenty of things I don’t know, obviously, but I am very comfortable learning things. I like learning things. Give me a subject I don’t understand, and my instinct is usually some version of: Okay, fine. Explain the rules. Physics? Fine. There are rules. There is math. We can work with this. Medicine, though? I have somehow spent thirty-one years occupying a human body with almost no understanding of its operations. This feels like an oversight.
My daily understanding of my body is “Seems operational to me!” and move on.
Of course, I know the normal things you pick up by existing in the world. I know generally where my organs are. I understand their broad job descriptions. Heart: blood. Lungs: oxygen. Kidneys: filter your blood and remove waste. But standing in an emergency room, listening to people talk about tests and measurements and possibilities, I realized how little I actually understand about the machinery keeping me alive every day.
More importantly, I realized that I didn’t know enough to identify what I wasn’t being told. How would I know whether they had ordered all the tests they should? How would I know whether there was something else they should be checking? How would I know whether a result was reassuring, concerning, or mostly meaningless without the context of five other things? I didn’t. Divya did. So when she asked whether they had checked something and I could say yes, I wasn’t just getting reassurance about that particular test. I was slowly getting reassurance about the process itself. Everything she expected them to be thinking about, they seemed to be thinking about.
Dr. Cole kept passing the Divya Audit.
Seventeen Thousand Questions
There is something I had never really appreciated about bedside manner before this week. Knowing medicine is one skill; taking all of that knowledge and translating it for someone who doesn’t have it is another. I encounter a version of this in my own work when I’m explaining the legal system to someone who doesn’t live inside it every day. I learn again and again that expertise isn’t only what you know. It’s also how well you can help someone else understand it.
Every doctor and nurse I interacted with that night was lovely, and their jobs are not easy. They move between rooms and people and problems, carrying an enormous amount of technical knowledge while interacting with patients and families who may be having one of the worst days of their lives. They have to know what to do, of course, but they also have to explain what they are doing to people who may have absolutely no idea what any of it means.
No one ever made me feel like my questions were an inconvenience, even as I continued producing them. At one point, Dr. Cole came back into the room and said, “So, I’ve been thinking.” Then he disappeared again, which was not ideal timing for suspense. A minute later, he came back. “I think we can discharge you.” Possibly the best conclusion to anyone’s thought I have ever heard.
Before I left, I told him, “Thank you for answering all my questions and being so patient.” “Of course,” he said. “I’m here to help.” Somewhere between Who is this random man attempting to enter this room? and thank you for answering all my questions, I had come to trust him. He had explained his reasoning, welcomed questions, treated me like understanding what was happening mattered, and, yes, kept doing the things that another doctor I trusted expected him to be doing.
I left the emergency room with a tremendous appreciation for people who know things I do not. I also left thinking: I need to learn medicine.
I Need to Learn Medicine
Okay so I’ll admit, I looked into part-time nursing programs that I can start after I complete my MBA. I mean, I’m already enrolled into Johns Hopkins, I can just add another degree?
But, I don’t think I’m suited for med school at all, I’m too queasy and am faint of heart. And currently, I have enough degrees in progress and hypothetical future degrees floating around my head already. Nor do I mean that I would like to diagnose myself, interpret my own test results, or replace actual medical professionals with a textbook and an unreasonable amount of confidence. But, I want to know more.
I want to understand the basic systems. I want to know what common tests are actually measuring. I want enough vocabulary that when someone explains something to me, I understand more than the nouns. I want to know enough to ask better questions. Mostly, I want enough of a framework that the next time I encounter medicine, it feels a little less like being dropped into a country where everyone else speaks a language I never learned.
I will, for the record, continue texting Divya (probably constantly). Learning more about medicine is unlikely to decrease the frequency with which I call my best friend who actually went to medical school. If anything, I suspect it will improve the quality of my questions. There is something particularly comforting about having someone you love who understands a world you don’t. Divya didn’t just understand the medicine; she understood me. She knew when I needed an explanation, what I was actually asking, and which pieces of information would make the rest make more sense. When I didn’t know whether I could trust my own assessment of what was happening, I could trust hers.
And I think that is part of what this week reminded me: learning more does not mean needing other people less. I can learn what the kidneys are doing and still text Divya. I can understand what a test measures and still ask a doctor what it means in context. Knowing more does not eliminate the need for expertise. If anything, I suspect it makes you appreciate expertise more, because you begin to understand just how much there is to know.
A Tort is a Civil Wrong
The funny thing is that there was a time when my world was the unfamiliar one. Before Divya went to medical school, she took an introductory law class one summer. I had just finished my first year of law school, and I remember being delighted when she started telling me the things she was learning. Most memorably: “A tort is a civil wrong!!!”
I loved it. There was something adorable about hearing one of my best friends discover the very basic building blocks of this enormous subject I had spent the previous year learning. Of course, knowing that a tort is a civil wrong does not make you a lawyer. But it gives you one little piece of the language. Then you learn another. And another. Eventually, things that once sounded completely foreign start fitting together.
This week, I was on the other side of that exchange. Divya was the person who could listen to a few words and immediately understand the larger system they belonged to. She could ask the next question because she knew what the next question should be. And I kept thinking about how extraordinary it is that I have known her since before she knew any of this. I remember when a tort is a civil wrong was new information. Now she is the person I call from the emergency room when I need someone to help me understand whether everything that should be happening is happening.
Today, I asked if she still had any of her medical school review books. She did. “It’s dense,” she warned me, before adding, “but it’s all yours.”
So, I guess we’re doing this.
I am under no illusion that reading a medical school review book will make me a doctor, just as learning that a tort is a civil wrong did not make Divya a lawyer. Expertise is real, and if anything, this week made me appreciate it more. There will always be people who know more than I do. There should be. There is something wonderful about living in a world where other people have spent years learning things I have not, and where sometimes I get to put myself in their hands. But I would like to understand a little more of what they know.
Years ago, Divya learned a little of my language. Maybe it’s time I learned a little of hers.
Until next time!
xo
Sandhya
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