Connecting Through Shared Vulnerabilities

“Sweet are the uses of adversity which, like the toad, ugly and venomous,
wears yet a precious jewel in his head.”

-William Shakespeare

“I’m really scared Doc,” said my patient Donna, as we finished up our telemedicine visit last week.

Ordinarily, I’d try to be reassuring, and say something like, “It sounds like you’re really worried, and I’m going to help you through this.”

This time though, the first words that came to me were, “I’m scared too.”

As I reviewed the current COVID-19 precautions with Donna and said that I’d be here for her as we both worked to avoid this frightful illness, I felt a closeness and connection that I’ve rarely felt in patient care.

“Thank you, and you take good care of yourself too,” she said as we ended our call.

After reflecting, I concluded that what I felt was the fruit of shared vulnerability and humanity.

Embracing vulnerability

In her 2017 Harvard Medical School commencement address, Dr. Colleen Farrell highlighted how embracing one’s own vulnerability can help clinicians deepen empathy and compassion for patients. She described how she derived strenth from sharing her struggle with depression:

“It was scary—just like it’s a little scary telling you this story today—but I learned that my vulnerability was rich, fertile soil for my own healing and growth, for forging more meaningful relationships and for gaining a deeper understanding of my patients.”

When a clinician experiences the patient role, especially in the case of serious of life-threatening illness, it deepens their understanding of the patient perspective. There is perhaps no better example than Dr. Rana Awdish’s honest and illuminating memoir “In Shock,” in which she chronicles her near death experience from hemorrhagic shock and multi-organ failure. Reflecting on her harrowing experience, Awdish shares opportunities to improve the doctor-patient relationship:

“Our ability to be present with each other through our suffering is what we are meant to do. It is what feeds us when the darkness inevitably looms. We cannot avoid the darkness, just as we cannot evade suffering. Loving each other through the darkness is the thing to look for and to mark. It’s there, in the shadows, where we find meaning and purpose.”

Most of the time, clinicians are relatively healthy when giving diagnosis, treatment, and guidance to patients who are suffering. To convey the empathy that is central to the healer’s role, we try our best to imagine what it might be like to walk in our patients’ shoes. But with COVID-19, we’re all vulnerable. I can’t recall another time in my career when I sat with patients as we shared a common, immediate fear for our lives. The closest thing was 9/11, when all Americans shared a common sense of terror and confusion. Treating patients during the early months of the AIDS epidemic was worrisome, but specific risk factors were quickly discovered and preventive measures taken to keep healthcare providers safe.

All clinicians now share a common vulnerability with patients, and this will be the case for many months to come. Hospital-based, bedside caregivers are far more vulnerable than the average citizen, as they are exposed to increasing numbers of infected patients each day. Transparency about these fears is important for our emotional health, and doesn’t diminish our ability to be effective clinicians.

Author and researcher Brene Brown, who has lectured extensively on vulnerability, reminds us that,

“Vulnerability is not weakness; it’s our greatest measure of courage.”

The COVID-19 pandemic has already taken a tragic toll around the world. Yet, as in all adversity, there is strength and wisdom to be gained. Clinical excellence and shared vulnerability are not mutually exclusive. In fact, they reinforce a caring connection.