My white coat waits in the corner like a father. I will wear it to meet the sister in her white shoes and organza dress in the live of winter, the milkless husband holding the baby.
I will tell them.
They will put it together and take it apart. Their voices will buzz. The cut ends of their nerves will curl.
I will take off the coat, drive home, and replace the light bulb in the hall.
Guiding Discussion:
Giving devastating news to families counts as one of the most difficult and profound aspects of our work as emergency physicians. And yet, after conversations with families that permanently change their lives, we move on to the next task. The speaker in this poem describes what he (or she) believes will be the response of the family and that he’ll drive home to “replace the light bulb in the hall.” Is the physician “burned out” and separated from the impact of his words or simply professional and skilled at compartmentalizing his work life from home life?
John Stone uses some interesting language in the poem. Circle the words that stand out, either for their imagery, unusual usage, metaphorical implications. Think about what the poet may have been trying to say with those words. Take a minute or two and write as many other words the poet may have used instead. Then take another two minutes and write as many words that describe your own experience of giving difficult news, and the experience afterwards when you move on. What do you find most challenging? Rewarding or profound
What is the white coat in this poem? For example, does it serve as a symbol of identify? Operate as an emotional shield? Do you have a work identity that’s left behind at the end of the shift. Are you a “different person” at work?
When you finish telling families bad news, do you consider that task finished? Do you think about what the families or friends next steps will be? If you don’t, why is that? Is it beyond your control? Is it too emotionally difficult?
Exercise:
Could you take the words from guiding question #2 and write a short poem or a few paragraphs that describe your own experiences after giving bad news or after being involved in emotional demanding clinical experiences. If you’re in-training or a young attending, you may want to describe your fears or concerns. If you’re more seasoned, you may consider what you’ve learned over the years, how you’re practice has changed, and/or what you would say to your younger self.
You may choose to share what was written with the group or keep it private. The group should come together, and incorporating as many insights as possible, develop a ‘working draft’ that lays out strategies that recognize and address what physicians might be going through—often alone—after being involved in emotional demanding clinical experiences.
About the author: John Stone, MD. was an acclaimed poet, essayist and cardiologist, as well as a medical educator and champion for the medical humanities in medical education.
