I had just dropped off the patient in the post-operative recovery unit after surgery to correct a problem in his right leg when the nurse called with an urgent message.
"The patient is complaining of 10 out of 10 pain in his left leg. Do you think it may not be getting enough blood?"
This was an urgent question, one that I received frequently during my vascular surgery rotation. If his leg were indeed ischemic — lacking adequate blood supply — he could lose his limb if we didn't act fast.
"Does he have a pulse in that leg?" I asked her. "It's a strange coincidence that his left leg is symptomatic now because we just operated on his other leg."
"I can't feel a pulse anywhere. Can you please come to make sure?" she pleaded.
So much for my hoped-for break after many hours in the operating room. I planned to grab a snack at the cafeteria before answering all the patient-related calls I had missed during surgery.
As I rushed back to the recovery unit, I wondered whether I was going to find a true emergency. Many patients like this man have hard-to-detect pulses because of their underlying disease.
My other thought: Why me? Why do I have yet another demand placed on me when I have so little time and energy to spare?
I am sure I wasn't as cheerful as I could have been when I met the nurse and my patient. But it turned out that he did indeed have an ischemic, "cold" leg. We went back to the operating room that afternoon to operate on the left side. The patient was discharged home several days later, pain-free, thanks to the nurse's astute judgment.
This episode has changed the way I see such encounters — and not just because I am so grateful my patient escaped what could have been a dire consequence.
As I reflected on my self-centered thoughts on the way back to my patient, I remembered something I once read.
The late writer David Foster Wallace talked about feeling like everything seems to be stacked against you. You're tired and stressed at the end of the day, the traffic is terrible, you have to get groceries, the checkout line barely moves, and then the cashier is rude.
This is when, Wallace wrote, we tend to think "situations like this are really all about me. About my hungriness and my fatigue and my desire to just get home."
That's our natural default setting, he wrote. We have to make a conscious decision about how to think about such circumstances, unless we just want to get upset whenever we face a problem.
I hit this natural default setting after the nurse called me. I wanted to assume that she might be overly cautious. Especially because I had just finished the surgery. Her request felt inconvenient and even unfair.
Those irrational thoughts didn't slow me down from caring for my patient or from thanking the nurse profusely. But they did prompt me to change how I think of my daily encounters.
Remembering that I can always choose my perspective has provided me with an invaluable lens through which to view these episodes. There will always be alarms, false or not, and they may come at times that are personally inconvenient. But instead of falling into default mode, now I challenge myself to consider alternative scenarios that aren't all about me.
When we applied to medical school, we were asked to write about our passions, ambitions, and ideologies. But in real-life medical practice, if all we can think of is our own narrative, it is easy to feel frustrated when others don't share that path.
As Wallace said, "I can choose to force myself to consider the likelihood that everyone else … is just as frustrated as I am, and that some of these people probably have harder, more tedious and painful lives than I do."
Perhaps the person calling me is under even more duress than I am and may have been up all night with an emergency. Perhaps he or she is a brand-new intern who is overwhelmed by the transition into the new role, a position I was in not too long ago. Even an unlikely scenario can help open our minds to a more considerate world view.
Think of it this way: Awareness is all that stands between a world that is unfair to you alone and a world that is challenging to many.
Though we may not be able to fix the world, in adjusting our perspective it is possible to change it, as we accept our power to experience even the most frustrating circumstances as meaningful and shared.