What is a Hero?
Randall M. Levin, MD, FACEP
I would like to now turn to the concept of “Hero” and what it means to medicine. Do we risk patient injury and medical errors because we look at ourselves as the “only one who has the ability to treat patients correctly” as Brian D. Wong, MD portrays in his book “Heroes Need Not Apply” or do we look at ourselves as heroes when we connect to our compassion and empathy as Frank Gabrin, MD so compassionately relates to in his journey from burnout and back in “Back from Burnout: Seven Steps to Healing from Compassion Fatigue and Rediscovering (Y)our Heart of Care,” Clear2Care Inc, 2013.
How you define the term “hero” can have significance, because if we need someone to label us as a hero, then we are not heroes. It then is about us and not the patient. This would be egotistic and not altruistic. We would be performing for ourselves not for others. Subsequently, if we are not looked upon as heroes by others, does this not lead us down the pathway to UnWellness and Burnout? It turns over control of our well-being to others. Do we have to know that others think of us as a hero to feel good, or does our well-being come from knowing that we are doing our best with all of our competencies? Again, the previous puts someone else in control of our well-being and the latter gives us the ability to take ownership of our well-being.
I have always postulated that the term hero is a third person definition. In other words, do we think of ourselves as heroes because of what we can do; or do we only do what we do because of our altruistic approach to society. The third person gives us that honor of being called a hero because society needs to know that there are people out there who will come to their aid, who will take care of them in time of crisis whether or not they are in the medical field, a first responder, in the armed forces or a layperson. When asked the question: Do you think that you are a hero? The most common response is: no, I was only doing what I was trained to do. I was only doing what any human being would do - I was being a human being. What they are exhibiting by their actions is the connection to their altruistic being, exhibiting empathy and exercising compassion. Instead of fight or flight response, they are drawn to their altruistic being.
Tony Buchanan, et al from St. Louis University has found that certain people respond to stress by “running” toward the disaster/stress. They have an altruistic approach when exposed to stress. Can we take this a bit further to say that those of us in medicine and especially emergency medicine have this innate reaction? This obviously may be seen in first responders, armed forces, etc. But this may not be the case for all members of any specific group. You can ask the question of why some doctors do not do well in emergencies. Or, how many doctors actually run to an apparent medical need when asked - is there a doctor in the house/plane/theater, etc. It is not just because we are trained to respond. We “need” to respond because we want to be true to ourselves and connect to the reason why we entered the field of medicine. Dr. Frank Gabrin describes this as being true caregivers. We have a sense of well-being not because we think we are heroes but because we are connected to our empathy and compassion as we utilize the skills we do have. One of the reasons for UnWellness is the inability to be truly connected to our altruistic being. Burnout strips us of the connection and ability to be who we are as healers.
When the “heroes” of our society (3rd person definition) perform at a disaster or terrorist attack, we see what they can do. Blockage to their altruistic being does not exist; they perform their skills (sometimes super human skills such as lifting cars) because they aren't blocked by the multi-factors which may block them in daily activity and daily practice. I postulate that if burnout is the loss of connection to oneself and one's purpose, it must be blocking the normal neurophysiological response (oxytocin) that those of us who have in exercising our altruistic behavior, as noted by Tony Buchanan and his group.
Therefore, with the scientific studies pointing to this response, lets now study ways to not only enhance these pathways to improve wellness but also to bring it into our everyday less stressful encounters (professionally and personally). This will allow us, on a daily basis, to nurture and maintain our connection to our true selves, our purpose, and our well-being to prevent burnout.
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