by Sergio Salazar, MD, MBE
The purpose of this editorial is to reveal how one of the most tragic events in our nation’s history helped teach future medical providers the influence that humanistic actions can have on relieving suffering and forward healing.
On June 12, 2016 the largest mass shooting incident in our nation’s history claimed the lives of forty-nine innocent victims at the Pulse night club in Orlando. The Pulse night club was frequented by the Latino LGBTQ community. The shooter was identified as a terrorist with extremist religious beliefs adding intolerance for alternative lifestyles and race to the massive loss of life. Due to the emotional turmoil experienced by everyone in the community, a session was prepared to provide a platform for discussion and closure for our students. Some students had been directly or indirectly involved in the care of the victims. The majority were like the rest of us, bystanders trying to come to grips with the senseless loss of life.
The longitudinal curricular themes (LCT) at the University Of Central Florida College Of Medicine include Ethics and Humanities. As with other aspects of medicine, learning becomes enhanced when the context of a lesson is presented as a real life scenario. After the mass casualty event known as the “Pulse” event, it was evident to everyone that the student body needed the opportunity to express their feeling regarding this tragedy. To meet this need, the faculty devoted one of the ethics and humanities LCT sessions to facilitate discussion using an expert panel format.
At the beginning of the session I saw the medical students coming in. They were tired and ready to “put their time in”. The Third year medical student class at UCF just finished their shelf exams. After the session, they would have a well-deserved week off until their next clinical rotations.
The facilitators of the session included a trauma surgeon that directly took care of the victims, a director of spiritual services, a medical student well versed in LGBTQ issues and an expert on crisis management. The introduction was a short video of an administrative official of a local hospital giving a description of the mobilization of services that occurred right after the event. The details of caring by the local community and medical personnel were displayed. A change began to occur.
The students sat up and began to pay more attention. During the description of the emergency preparedness and response, the selflessness of individuals displayed at every level of care was unmistakable. From physicians, nurses, ancillary services, spiritual care and volunteers that came in during their time off, to the outpouring of concern and empathy from our community, it was evident that lives were touched in such a profound way that their immediate response was to care.
The panel took questions and the students began their inquiry motivated by the need to know and heal. The questions facilitated a discussion that changed the dynamics of the learning sessions and left the students with life lessons in what it means to be a medical professional. From discussions regarding spiritual support to the families and victims, to acute medical care and beyond, the lessons in what it means to be human and care was palpable
At one point, the trauma surgeon was asked how he dealt with such a devastating night of serial surgeries and emotional turmoil. He began explaining that doing surgeries on gunshot wounds was something he did regularly and that the surgical care provided for these victims was no different. Then, he began to describe the need he felt to speak and comfort the families. His emotional description of his need to hold a hand, provide a kind work or even cry with the families to share in their pain, demonstrated what makes medical providers complete healers. By this time, the students where captivated.
It became clear that the things that make us similar are much more significant than the things that makes us different. It was plain to everyone in the session that at a time of crisis our distinctive physical or behavioral features are inconsequential.
As educators, we spend a significant amount of time teaching the technical and scientific basis of medicine. We attempt to augment student professionalism through ethics and humanities education during the first two years of medical school and intermittently approach the subject during the clinical years. I believe we can augment the teaching of ethics and professionalism by asking students to reflect on events that test our limits as providers.
Orlando experienced a devastating event. This event revealed the worst and best of humanity. The learning of what it means to be a physician must include not only competency in scientific and technical knowledge but it must require exercise of our human emotions for the betterment of our patients.