In medicine, I often find myself at the junction where people and their demon meet. Be it gravity, sudden deceleration, a drug of choice or even just plan bad choices; when these demons find their people, modern medicine comes to the rescue. Usually the incident is one of serendipitous misfortune. Over-corrected and rolled the car, slipped off the roof, or spoke up too soon and got shot. We often wonder how they found themselves in such a situation, when they could have avoided the risk. Whatever their opportunity was to not put themselves at risk, the reality is that we all take risks every day and it is by the grace of the Almighty that many more of us are not bare-ass naked in an E.R trying to explain "this has never happened before" and "I'm not really like this usually."
A more depressing, and more sinister dynamic, is when that thing that hurts is invited and allowed into one's life. Drugs are an easy example. Its a story that is so rehearsed and rehashed there is no need to detail its destructive nature. How can someone keep going back to something that ruins their life? We pass judgment and criticize how terribly weak and incapable they are to not take better care of themselves. We sneer and turn up our nose and even try to rehab them with "tough love". For someone who seems so disconnected from reality, it stands to reason that a reality check is the answer.
But when was the last time you were scared straight? Remember if you can, when a stranger told you, "its ruining your life, if you don't stop then you will loose everything!". This may sound more familiar as, "you are all going to burn in hell if you don't repent of your sin!" When has someone giving you a "reality check" ever caused you to change your behavior? A reality check is pure codswallop! People do not give us a reality check, reality puts us in check. We may think we can fly, but gravity says no. We may think we can dance, but our coordination (or lack thereof) says no. You may think you are safe, but the bruises say no. You may think you have it all figured out, but the flashing blue lights say no.
In healthcare, we may think that our position gives us some kind of moral authority over those who are struggling through life. My privilege and education give me capacity to care for and be compassionate to my patient and community; not to pass judgment or condemnation. The hell that people bring into their own life will not be transformed by adding gasoline to the fire of a life already turning to ash. Each and every one of us are one misstep, one wrong turn, one over correction, one DUI, one sexual misconduct accusation, one missed paycheck, one family tragedy, one bad habit, one leaked secret to suddenly finding ourselves being checked by reality. How empowered are you when people remind you of the failure you are? Perhaps you would be kind, knowing that the only difference between you and your patient is a badge and a pair of underwear; underwear mind you, that does little more then hide your shit where no one can see it.
Check out this amazing talk about how drug addiction's only cure is community. This is a reflection on how a way through many of our challenges is supporting each other, not isolating and condemning.