In Shock: My Journey From Death to Recovery and the Redemptive Power of Hope

Abstract

In this book, Dr Awdish shares a personal story, as a physician and as a patient. At 7 months pregnant, and still in her residency, she experienced catastrophic pain in her abdomen. She describes the experience of transitioning from being a physician to being a patient; from being the diagnostician to being diagnosed and unheard in a world of assumptions. Because she was pregnant and her pain was abdominal, she was told she needed to go to Labor and Delivery, even though she insisted she needed to be seen by a surgeon.Interestingly, she had demanded to be taken to the hospital where she was doing her critical care rotation as a resident, thinking that she would be able to communicate her needs and wants effectively. By the time her hemoglobin level was down to 3.0 mg/dL, a surgeon was notified; however, as in all teaching hospitals, a first-year resident was sent to evaluate her condition. Fluid and blood product resuscitation could not match her rapid blood loss. Although she was experiencing lapses in consciousness, she kept insisting that she needed to see the surgeon, who finally realized that emergent surgery was required to find and control the bleeding.Dr Awdish describes her experience of death on the operating table and her awakening postoperatively. Then she describes the recovery, the experience of not being believed about her level of pain, the multiple surgeries, and inadequate pain relief along with missed opportunities for her health care providers to administer patient-centered care. Throughout this story, Dr Awdish’s sense of separateness from her profession and her dawning understanding of the patient experience and how it is undervalued and under-respected by the health care team become clear. She survived, but I will not tell you the rest of the story—you must read it for yourself.From this personal experience, Dr Awdish finds her way to the “other side of the bed” with a new understanding of her patients’ need to be heard and the importance of listening without the preconceptions of medical knowledge. Meeting the expected standard of care is not enough—skilled communication requires us to pay attention to all the ways our patients and colleagues communicate.In Shock is an important book for health care providers. We may not all go through major crises like Dr Awdish did, but at some point we will all be patients. If we are lucky, we will have health care providers such as her or one of those she has trained to care for us.