Finding My Rhythm: Healing, Leading, Becoming

CARING

“for there is nothing heavier than compassion. Not even one’s own pain weighs as heavy as the pain one feels with someone, for someone, a pain intensified by the imagination and prolonged by a hundred echoes.”

_{Milan Kundera}

I was a urologic oncology fellow, rounding early one morning with my junior resident when we entered the room of a patient who had been in the hospital for a few days. His symptoms were vague. Low-grade fevers. Some abdominal discomfort. Fatigue. Nothing jumped off the page.

But he was immunocompromised — on high-dose steroids and other immunosuppressants. Patients like him don’t read the textbook. They don’t spike fevers. They don’t always show leukocytosis. Sometimes, by the time the signs are there, it’s too late.

As I examined him that morning, he spoke slowly, almost apologetically. His abdomen was soft, not overtly tender. He didn’t wince. He didn’t cry out. But something in the way he looked at me — the slackness in his face, the stillness in his body — unsettled me. I couldn’t explain it. I just knew.

I turned to my resident and said quietly, “I think there’s something brewing in his belly.”

We presented the case at rounds. I laid out the concern. “He’s not right. I think he has an intra-abdominal infection. Maybe peritonitis. I know the exam isn’t classic, but I don’t think we should wait.”

The attending gave a cursory look at the labs. “White count’s fine. Vitals are stable. Abdomen is benign. He’s immunosuppressed — everything looks a little off in these patients.” He moved on.

I stood still.

After rounds, I made a call — another attending on a different service. I laid out my concern, almost pleading. “He’s sick. I can’t explain it, but he’s not okay. I need someone to take another look.”

There was resistance. I was going against the plan. Challenging consensus. She hesitated. “You want to call general surgery on a soft belly with no fever or elevated white count?”

“I do,” I said. “Please.”

Reluctantly, I was allowed to consult general surgery. They sent a junior resident. He examined the patient and shrugged. “I don’t see anything surgical,” he said politely. “I’ll talk to my senior, but I don’t think we’ll do anything tonight.”

Still, I couldn’t shake the feeling.

I picked up the phone again — this time to my attending. “I know everyone thinks I’m wrong, but I need your help,” I said. “We need a senior general surgeon to see him.”

Something in my voice must have landed. He paused. Then finally: “Okay. I’ll make the call.”

The senior surgeon arrived that evening. I watched him examine the patient silently, pressing gently into the man’s belly, asking him questions. Then he stood up and looked at me.

“This patient is sick. We’re taking him to the OR now, tonight. Get him ready.”

The next morning, my resident came to find me. He had assisted during the operation.

“When they opened him up,” he said, “pus poured out. Everywhere. He had a perforated viscus. It was one of the worst cases they’d seen. He would have died if we’d waited.”

I stood there, flooded with emotion — relief, disbelief, quiet vindication. But also something deeper: the realization that I had nearly backed down.

Because I had doubted myself. Again.

I had felt this before — the inner knowing, the intuitive alarm — and still, every time someone more senior disagreed, that confidence wavered. I wondered if I was overreacting. If I was too sensitive. If I was making something out of nothing.

But that day, I didn’t yield. I didn’t silence myself. I stayed the course because I believed I was right — even when no one else did. That took courage. That took strength.

In The Hidden Leader, Scott Edinger writes that the most impactful leaders often aren’t the ones with the highest titles or the loudest voices, but the ones who consistently act with integrity, initiative, and insight — often from the shadows. That day, I became one of them.

Someone lived because I trusted what I saw. What I felt. What I knew.

Leadership, I’ve learned, is not about being right all the time — it’s about standing up when it matters most, even in the silence of doubt.

But it also made me reflect more broadly: Why is it so hard to speak up in medicine?

The culture of hierarchy, deference, and fear of being wrong can quietly erode our ethical instincts. We train people to follow protocols, respect seniority, and avoid “rocking the boat” — but in doing so, we sometimes discourage the very behaviors that save lives: intuition, moral courage, and dissent.

If we want to support ethical decision-making in medicine, we must create space for respectful questioning, for listening to quieter voices, for validating gut feelings — especially when they come from those lower in the chain of command.

We must teach that doing the right thing often means challenging the comfortable thing.

We must remind each other that leadership is not always granted by title, but revealed in moments of risk — when we advocate for the patient, for the truth, for what we know is right.

That day, I found my voice. But more importantly, I learned the kind of culture I want to lead: one where people feel safe to speak, even when they’re afraid. Especially when they’re afraid.

Because in medicine, silence isn’t just dangerous — it’s deadly.