Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Choreographing Clinical Care


Exceptional patient care is akin to a ballet performance. Synergistic team interactions, thoughtful decisions, and deliberate actions are all critical steps in the dance of patient care. 

As a dancer, working with my team in the ICU sometimes feels like a performance. Here’s how it goes:


Opening act: a dire scene 

The flicker of monitors and the whir of ventilators set the stage in the ICU. I watched as our patient, fresh from a complex Type A dissection repair, teetered on the edge of life and death. It was a sight that felt all too familiar, yet one that never loses its gravity. The night had been long, filled with intense concentration, tireless work, and the persistent drum of a beating heart echoing in the background. 


Adagio: a crescendo of alarm 

Their heart suddenly faltered. As the monitors screeched their alerts, the patient bled profusely from the chest tube. A surreal calm descended upon me, like the quiet before a dance’s crescendo. A premonition had stirred within me earlier. When Dr. Gammie, my attending physician who had just arrived, joined me at the patient’s bedside, I shared my concerns. And then, as if on cue, our dance began. 


Pas de deux: the team in sync 

In the midst of this orchestrated chaos, Dr. Gammie and I, partners in the operating room, found ourselves face-to-face with an unexpected encore. The urgency of the situation united us in a familiar dance, even as the setting deviated from the operating room’s controlled environment. 

As we approached the patient’s bedside, a silent understanding passed between us. Our partnership, honed through hundreds of surgeries, had prepared us for this moment. We became the embodiment of teamwork, our movements a seamless fusion of skill, trust, and shared experience. 


Coda: the final movement 

An intracardiac massage, shocks administered, relentless suctioning of blood–we moved with a heightened urgency, even as our hearts echoed the silence of our patient’s.   

I’ve seen life slip away before, and it was happening again. I had a sick feeling in my stomach. But just as despair threatened to cloud our focus, we found the elusive bleeding site. The repair was swift and sure, as deliberate and precise as the finale of a ballet. And just as the applause follows the final note, the resounding beep of a resurrected heartbeat filled the room. The ballet was complete. The patient would live. 


Curtain call: acknowledging the ensemble 

Exiting the ICU, I approached the waiting family. They’d been up all night too, caught in a horrible dance of their own–one of fear, hope, and desperate prayers. Sharing the news of their loved one’s survival, I saw relief replace worry–a different kind of ballet, one where fear gave way to joy. 

It was the tireless efforts of the ICU team, the anesthesiologists, the nurse practitioners, the physician assistants, the nurses, the respiratory therapists, and countless others, who provided the vital support and expertise needed to sustain our patient during the tumultuous performance.  


Encore: lessons for all 

What does it take to save a life? It takes an orchestra of skilled professionals, each playing their part in the ballet of medicine. It’s about nurturing that sense of intuition, having faith in the team, and knowing when to act. In this grand ballet of healthcare, every step, every twirl, every life saved, is a testament to the power of teamwork. 

Our mission as healthcare professionals goes beyond simply treating medical conditions–it’s about performing a ballet of healing, with every patient at the center of the stage. 


We navigate through the unpredictable scenes of the grand ballet of life, sometimes as leads, sometimes in supporting roles. Here are three tips to improve patient care, drawn from the theater of surgery: 


1. Listen to your intuition.

It often serves as an unseen guide, leading you to preemptive actions that could potentially save lives. 


2. Foster teamwork.

A harmonious team dance ensures smoother care delivery and better patient outcomes. 


3. Be resilient.

There will be stumbles and missteps. The key is to persist, adjust, and keep dancing, because the show must go on. 


Every interaction, every decision, and every action is a step in this dance. And it is our duty to ensure that this leads to a healthier tomorrow for our patients. 







This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.