“What kind of scar will I leave?” – Thoughts on our Lasting Impressions

Impressions.
As caregivers, we leave lasting impressions on virtually every patient and family we touch. We strive, of course, for those impressions to be positive. But the reality is much of what a patient experiences while in our care is anything but positive: pain … a devastating diagnosis … a discouraging prognosis. These unescapable “scars” are unfortunately part of illness or injury. As caregivers, perhaps one of our most important roles is finding ways to diminish inevitable distress.
Recently, a physician leader in one of our partner hospitals related a compelling story that had a profound influence on how he thinks about his role as a caregiver. The story he shared has had a lasting impact on the way I’ll now think about what our ultimate goal should be in providing memorable, exceptional experiences for patients and families.
As a young medical student, my friend had the option in one rotation of spending eight weeks in a major urban medical center or in a remote rural community with a solo practitioner. He chose the latter, thinking that he would get a more diverse, hands-on experience. That indeed he did.
In the first few days of the rotation, he scrubbed with the general surgeon in the small community hospital. As the team was ready to start the procedure, the surgeon looked at him and said, “Do you want to cut?” Enthusiastically, under the watchful eye of the experienced surgeon, he made his first incision. But it was the experience at the end of the operation that he remembers just as well.
Since it was an abdominal incision, he expected the surgeon to use standard staples to close the surgical site. Instead, he carefully applied subcutaneous sutures with all of the skill and patience of an experienced plastic surgeon. When the surgeon was finished, you could hardly tell there had ever been an incision.
Over a cup of coffee in the doctors’ lounge following the procedure, he asked the surgeon why he chose that particular suturing method. “They can’t see what’ve I’ve done internally; they just expect it to be right,” he explained. “But they’ll see and live with that scar for the next 20 years. I want it to be perfect. I always think about what kind of lasting scar I leave.”
What kind of “scar” we’ll leave is an important question for all health care professionals to consider. The fact that we are given the opportunity – and challenge – to care for fellow human beings at some of the most vulnerable times in their lives carries with it enormous responsibility to thoughtfully consider the lasting impact our work will have every day. Patients and family members in our care deserve nothing less.

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