Background

In every facet of healthcare, we are faced with uncertainty.  Despite various strategies to reduce this uncertainty, such as the use of evidence-based guidelines, we are often still unable to know with certainty whether we have arrived at the correct diagnosis, have designed the optimal treatment plan, and/or have accurately predicted a patient’s prognosis. Some have described this as “the fog of healthcare” a reference to the well-known “fog of war”. This lack of certainty can be both frustrating and disquieting, especially when we are faced with the responsibility of making decisions that could have a major impact on the health of our patients and their families.

Uncertainty has its benefits – it can lead us to a closer examination of the information we have available, to a deeper contemplation of the situation at hand, and to more effectively joining with our patients in a partnership to find the best way forward, many of whom will find comfort knowing that their providers are not “hiding” information and are being open and honest with them. At the same time, uncertainty is challenging, both because we have to find a way to communicate our uncertainty with our patients and (perhaps even more troubling) it forces us to wrestle with feelings of insecurity and can lead us to question ourselves and out value as physicians –  the so-called “imposter syndrome.”

Being able to navigate a path through uncertain situations requires us to be vulnerable -both with ourselves and with others – and something that Dr. Brene Brown points out in the linked TED talk above, may be the best measure we have for courage. This can be particularly difficult for physicians, who often want to project a sense of confidence and perfection. That said, vulnerability is what lies at the root of human connection, and establishing human connection with peers, patients, and co-workers is fundamental in the field of Family Medicine (and life).

Assignment

Please watch the TED talk by Brene Brown and review the “Man in the arena” quote by Theodore Roosevelt (below).  Come prepared to discuss the following questions:

1) What does vulnerability mean to you?

2) What kind of situations make you feel vulnerable?  How do you deal with these situations?

3) Think of a particular time that you had to cope with uncertainty and felt vulnerable.

4) Reflect on your personal context, including experiences growing up, as a young adult, and in your professional life.  With that in mind, consider the sources of your reactions to (a) this uncertain situation and (b) feeling vulnerable in general.

5) How did you handle the situation?  If this situation arose again, would you handle it differently?