Dr. Edmonds: The moment I knew medicine was my calling

AMA Wire
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Physicians are privileged to see patients at their most vulnerable, to reshape lives and continually revitalize the nation’s health system. In a challenging practice environment, physicians remain driven by the power of healing and the indelible connections they form with patients and families.

The AMA Wire®When I Knew I Medicine Was My Calling” series profiles a wide variety of doctors, offering a glimpse into the lives of the busy women and men navigating new courses in their careers and in American medicine. No matter their age, their specialty or their career stage, they were born to do this and they tell us why.

Share a moment with: Kyle P. Edmonds, MD, palliative medicine physician at University of California, San Diego Health.

I was born to: Listen and learn.

An experience from residency that confirmed my calling as a physician: As a senior resident on night float for our inpatient family medicine service, I would assist the day team when I had the time by drilling down into symptom management or advance-care planning for certain patients. This often led to fantastically deep conversations and sharing of stories with patients late in the evening or early in the night. There’s a lot to be learned about people when the hospital is quiet, the TV options are boring and the interruptions are few.

An experience from medical school that kept me going: I screwed up during my first few weeks of my first rotation of third year—I was lost and bored and I thought that no one would notice that I was being avoidant. In my mid-rotation feedback session with the program director, he saw me and was firm but kind in his redirection. He was, in many ways, the person who helped me find my way into a successful survival of third year. I ultimately honored that rotation. And now, as a course director, I use his approach.

My source of inspiration: I read Dr. Atul Gawande’s first two books, Complications and Better, when I was in my pre-clinical years of medical school and they have served as the foundation of my approach to medicine as a thought-provoking, flawed, beautiful, human endeavor that calls on us to be curious, flexible and knowledgeable.

My hope for the future of medicine: That we rediscover the true value—in every sense of that word—of teamwork and end the bizarre fiscal incentives that have left physicians as the only financially viable member of most health care teams. By ensuring that a team of professionals is working together, we will have the time and expertise to ensure that patients are being seen as whole people in the context of their lives. Palliative care teams spend a great deal of time striving for this type of team and are a workable model for the way forward.

The hardest moment in medicine and how I got past it: As a palliative fellow, I spent time in an inpatient hospice setting where, on one quiet Saturday morning, I got to know the parents of a young woman who was dying. They were extraordinarily loving and bereft, as they had fought hard for her to be their daughter and then alongside her through grueling cancer-directed therapies. In many ways, the patient reminded me of my son and the parents reminded me of his mom and me. It was a perfect storm of my own issues, both personal and being several months into a life-changing fellowship, and their grief. Though I almost never bring the emotions of my cases home with me, this one required me to cry and to share it with trusted friends. It taught me a great deal about the value and difficulty of equanimity—of bringing a “strong back and a soft front” to my interactions with patients and their circle of support.

My favorite experience working with the medical team: My whole job, as a palliative specialist, is to work with tremendously qualified experts from multiple disciplines (nursing, social work, pharmacy, chaplaincy, physician learners) on a team to achieve our goal of improving our patients’ quality of life. So the cop-out answer is that every day in my world is a great team experience, but there are some days when each of us is able to bring the best assessment skills to the bedside of a patient. Those days, our teams’ ability to be a pressure-relief valve for patients, families, and the larger care team is really palpable.

The most challenging aspects of caring for patients: Nearly every patient I see as an inpatient palliative consultant is in a medical gray zone, struggling to find their way to better function or better symptom control and, as such, it requires all my natural optimism to keep ahold of my equanimity and perspective.

The most rewarding aspect of caring for patients: Learning each person’s stories and finding out, to the best that our time together allows, what it is that makes each patient tick.

The skills every physician should have but won’t be tested for on the board exam: Curiosity and humility, as well as a thorough awareness of self—what brings you joy? What makes you angry? What makes you cry? Only in this way can a physician know how to best care for each person in front of them.

One question students should ask themselves before pursuing medicine: Do I know myself well enough to ask myself—and my patients—the hard questions and be ready to be a small part of incredibly important life events?

A quick insight I would give students who are considering medicine: It’s both harder and more rewarding than it looks.

Mantra or song to describe my life in medicine: “No agenda” is my mantra as it reminds me that each person I meet has a story that I need to hear before I make assumptions. For a song, there’s no better one than “Finishing the Hat,” by Stephen Sondheim, to describe what it’s like to be enmeshed in a profession that no one else can quite understand.

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Comments

This series is so good! I love it. It's so important to have your own circle of support as a physician, as you say, so you can bring your best to your patients as well.
Show Comments (1)
Apr 24, 2017
A social psychologist says that only by addressing breakdowns in physician engagement on a systemwide level will the incidence of burnout diminish.