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Behind the Mask: How Do I Maintain My Sense of Empathy?

Behind the Mask: How Do I Maintain My Sense of Empathy? Clin Orthop Relat Res (2022) 480:1270 DOI 10.1097/CORR.0000000000002234 Published online: 9 May 2022 Behind the Mask Copyright © 2022 by the Association of Bone and Joint Surgeons Steven E. Zhang MD rthopaedic surgery is closely collapse, the patients work their way “This is not a battle that we win, nor tied with intravenous drug use down to their legs and feet. do we break even,” Dr. Liu said. O(IVDU). The tip of the needle We had a young man present to our I would guess that about half of the hits the limb first and the physical emergency room with orthopaedic com- patients on my hand surgery rotation were devastation soon follows. We might plications from IVDU. Maybe he finally admitted for a problem related to drug use. not be able to see the distorted dopa- checked himself into the hospital because I found each of these encounters slowly mine networks of an addicted person’s of the pain from his open sores, or perhaps chipping away at my ability to empathize. brain, but the abscesses from skin he was concerned with the dusky appear- If this much misery from their addiction popping and the gangrenous fingertips ance of his legs. His father came to visit won’t convince them to quit, then what and toes are all too visible. him the next day. Together, they asked the am I supposed to do? But I remind myself Patients who use intravenous drugs team to salvage his leg, and so we took that we aren’t just a hospital for them— usually start with their forearms and him to the operating room later that eve- we are their last resort. I asked Dr. Liu hands, but there are only so many veins. ning. We saved whatever tissue possible how he maintains empathy in a battle that When the vessels of the arms begin to and closed his wounds as best his skin he knows he will never win. would allow. We knew this would be a “[Demonstrating] compassion to challenge, and we did not know how long someone beyond what they perceive as until his skin would remain closed since he deserving so they may obtain a feeling of A Note from the Editor-in-Chief: In this quarterly column, third-year resident Steven was not in treatment for his addiction. self-worth, which is a void they other- Zhang MD takes us inside his intense training We did our job, but there was no wise have trouble filling—that’sthe environment at the University of self-congratulation. After doing power of medicine and the connection Pennsylvania, where at the end of the busy enough bedside debridements and we have with our patients,” Dr. Liu said. day, he is often left with more questions than amputations for patients with ortho- A young girl who had been injecting answers. We welcome reader feedback on all of our columns and articles; please send your paedic complications from IVDU, one into her fingers presented to one of our comments to eic@clinorthop.org. starts to lose any sense of accom- community hospitals in the middle of the The author certifies that there are no funding plishment in this context. night. The skin on her hand was pock- or commercial associations (consultancies, Dr. Stephen Liu is a Clinical marked from skin popping. Half of her ring stock ownership, equity interest, Assistant Professor of Orthopaedic patent/licensing arrangements, etc.) that finger was gone, the distal end of it was might pose a conflict of interest in connection Surgery and a hand surgery attending at already necrosed and unsalvageable. She with the submitted article related to the author Penn Medicine in Philadelphia, PA, begged that we save as much of thefinger as or any immediate family members. USA. Dr. Liu has treated many patients we could. She said it was her wedding ring All ICMJE Conflict of Interest Forms for au- with orthopaedic complications from thors and Clinical Orthopaedics and Related finger. We took her to the operating room in IVDU and is all-to-familiar with the Research editors and board members are on the late evening and debrided her finger, file with the publication and can be viewed on problems they face. I asked him bluntly, saving as much healthy tissue as possible. request. and perhaps naively, how many of these Our infectious disease colleagues met The opinions expressed are those of the writer, encounters had a happy ending. and do not reflect the opinion or policy of with her to follow her cultures. A team of CORR or The Association of Bone and Joint nurses changed her dressings every day. A Surgeons . social worker visited her to arrange her S. E. Zhang ✉, University of Pennsylvania 1 rehabilitation stay. She stayed with us for a Perelman School of Medicine, 3737 Market Orthopaedic Resident, University of week and then she left to go into recovery. Street, Philadelphia, PA 19104, USA, Email: Pennsylvania Perelman School of Medicine, steven.zhang@pennmedicine.upenn.edu Philadelphia, PA, USA A win is a win. Copyright © 2022 by the Association of Bone and Joint Surgeons. Unauthorized reproduction of this article is prohibited. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Clinical Orthopaedic and Related Research (CORR) Wolters Kluwer Health

Behind the Mask: How Do I Maintain My Sense of Empathy?

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Publisher
Wolters Kluwer Health
Copyright
© 2022 by the Association of Bone and Joint Surgeons
ISSN
0009-921X
eISSN
1528-1132
DOI
10.1097/corr.0000000000002234
Publisher site
See Article on Publisher Site

Abstract

Clin Orthop Relat Res (2022) 480:1270 DOI 10.1097/CORR.0000000000002234 Published online: 9 May 2022 Behind the Mask Copyright © 2022 by the Association of Bone and Joint Surgeons Steven E. Zhang MD rthopaedic surgery is closely collapse, the patients work their way “This is not a battle that we win, nor tied with intravenous drug use down to their legs and feet. do we break even,” Dr. Liu said. O(IVDU). The tip of the needle We had a young man present to our I would guess that about half of the hits the limb first and the physical emergency room with orthopaedic com- patients on my hand surgery rotation were devastation soon follows. We might plications from IVDU. Maybe he finally admitted for a problem related to drug use. not be able to see the distorted dopa- checked himself into the hospital because I found each of these encounters slowly mine networks of an addicted person’s of the pain from his open sores, or perhaps chipping away at my ability to empathize. brain, but the abscesses from skin he was concerned with the dusky appear- If this much misery from their addiction popping and the gangrenous fingertips ance of his legs. His father came to visit won’t convince them to quit, then what and toes are all too visible. him the next day. Together, they asked the am I supposed to do? But I remind myself Patients who use intravenous drugs team to salvage his leg, and so we took that we aren’t just a hospital for them— usually start with their forearms and him to the operating room later that eve- we are their last resort. I asked Dr. Liu hands, but there are only so many veins. ning. We saved whatever tissue possible how he maintains empathy in a battle that When the vessels of the arms begin to and closed his wounds as best his skin he knows he will never win. would allow. We knew this would be a “[Demonstrating] compassion to challenge, and we did not know how long someone beyond what they perceive as until his skin would remain closed since he deserving so they may obtain a feeling of A Note from the Editor-in-Chief: In this quarterly column, third-year resident Steven was not in treatment for his addiction. self-worth, which is a void they other- Zhang MD takes us inside his intense training We did our job, but there was no wise have trouble filling—that’sthe environment at the University of self-congratulation. After doing power of medicine and the connection Pennsylvania, where at the end of the busy enough bedside debridements and we have with our patients,” Dr. Liu said. day, he is often left with more questions than amputations for patients with ortho- A young girl who had been injecting answers. We welcome reader feedback on all of our columns and articles; please send your paedic complications from IVDU, one into her fingers presented to one of our comments to eic@clinorthop.org. starts to lose any sense of accom- community hospitals in the middle of the The author certifies that there are no funding plishment in this context. night. The skin on her hand was pock- or commercial associations (consultancies, Dr. Stephen Liu is a Clinical marked from skin popping. Half of her ring stock ownership, equity interest, Assistant Professor of Orthopaedic patent/licensing arrangements, etc.) that finger was gone, the distal end of it was might pose a conflict of interest in connection Surgery and a hand surgery attending at already necrosed and unsalvageable. She with the submitted article related to the author Penn Medicine in Philadelphia, PA, begged that we save as much of thefinger as or any immediate family members. USA. Dr. Liu has treated many patients we could. She said it was her wedding ring All ICMJE Conflict of Interest Forms for au- with orthopaedic complications from thors and Clinical Orthopaedics and Related finger. We took her to the operating room in IVDU and is all-to-familiar with the Research editors and board members are on the late evening and debrided her finger, file with the publication and can be viewed on problems they face. I asked him bluntly, saving as much healthy tissue as possible. request. and perhaps naively, how many of these Our infectious disease colleagues met The opinions expressed are those of the writer, encounters had a happy ending. and do not reflect the opinion or policy of with her to follow her cultures. A team of CORR or The Association of Bone and Joint nurses changed her dressings every day. A Surgeons . social worker visited her to arrange her S. E. Zhang ✉, University of Pennsylvania 1 rehabilitation stay. She stayed with us for a Perelman School of Medicine, 3737 Market Orthopaedic Resident, University of week and then she left to go into recovery. Street, Philadelphia, PA 19104, USA, Email: Pennsylvania Perelman School of Medicine, steven.zhang@pennmedicine.upenn.edu Philadelphia, PA, USA A win is a win. Copyright © 2022 by the Association of Bone and Joint Surgeons. Unauthorized reproduction of this article is prohibited.

Journal

Clinical Orthopaedic and Related Research (CORR)Wolters Kluwer Health

Published: Jul 9, 2022

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