• The Editor

Why are we taught to hide something so valuable?

By Samuel Goldman, MD, MPH

I feel the weight of my skis dragging me down toward the white void below. A snowflake on my gloved hand, perched precariously on a stray wool fiber, reminds me of my insecurity. It melts into oblivion as I tighten my grip around my five-year-old daughter, chairlift swaying gently. It’s her first ride. I hate heights.

“Daddy, I’m scared,” she says.

“See that thick steel cable holding us up?” I almost release my death grip to gesture upward. I don’t, and pull her closer instead.

“You’re safe,” I say, watching her gaze defy reassurance. Can she feel my hands shake through our collective layers of puffy clothing? Her face mirrors my fear. It’s the damn bunny hill, too.

Parenting is a series of smoke-and-mirror acts to guide your children through new experiences. What fears did my parents hide from me?Was I teaching my daughter that her fear is unnecessary, something to be hidden? What is the cost of that lesson? As a resident emergency physician, I feel like I’m hiding, too.

I once cared for a man in his forties who fell thirty feet from a ladder. (Roughly, say, the height of a chairlift). The patient came under my care in the Trauma ICU late in the evening after emergency surgery—abdomen left agape, dressed only with a transparent bandage. His belly looked like a bowl of leftovers covered in cellophane.

The next morning, I went to his bedside. I look at his monitor. The red digits of his arterial blood pressure tracing read 88. I notice a trickle of blood seeping from the edge of his wound. I stare in horror at the red numbers: 87...86. Blood pools on the bed. 85...84. I put my finger on his femoral pulse. I call for nurses. I call for blood. I call for help. 83...82...81.

I remember reading that a patient loses their femoral pulse when the systolic blood pressure hits 70. Turns out, that’s true. The wound is leaking all over the floor when I stop feeling it. I call a code. Fear is buried by action. A swarm of yellow-gowned nurses tear open medications, bags of blood are squeezed like juice boxes wrung of their last sips by thirsty children. The sunrise bounces off Narragansett Bay and into the room as the senior resident and attending surgeon arrive. The man’s pulse returns. He is wheeled to the OR. A trail of red follows his stretcher down the hall.

In our profession, we often mistake terror for incompetence. Fear is shameful. We learn to repress our uncertainty. We hide it from our patients and each other. We reassure our patients and colleagues with feigned calm and forced bravado. As a result, we have much less to offer when we hide it from ourselves.

The hard truth is that I’m often terrified by what I see in the hospital.

Some suggest my fear stems from Imposter Syndrome, dismissing it as a form of self-doubt or lack of self-awareness. But I resent the dismissiveness of this label. I want fear to remain. I want to feel like the stakes are always as high as my kid falling off a chairlift. Fear forces vigilance. It makes me hold my child tighter, it spurs calls for help, it points us in the direction of action. Why are we taught to hide something so valuable?

Photo by Andrew Kosobokov on Unsplash

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