The night he left, I laid in bed for hours trying to sleep. My mind raced and my heart ached. I couldn’t stand the silence, but there was no music I wanted to hear, no show I wanted to watch, no person I wanted to speak to. In search of a comforting sound, I reached for the stethoscope on my desk, placed the buds in my ears and the diaphragm on my own chest. I closed my eyes, cleared my head and tried to concentrate on the familiar sounds.
Lub-dub, lub-dub, lub-dub . . .
I instinctively analyzed them. 72 beats per minute. Regular rate and rhythm. Normal S1, normal S2. No murmurs, rubs or gallops. It was an ordinary heart. Steady, reliable, certain. I breathed a quiet sigh of relief. “You’re okay,” I thought to myself. Apparently my heart was indifferent to heartbreak, and this fact brought me peace. So I continued to listen.
Lub-dub, lub-dub, lub-dub . . .
It was a song I heard every day with slight variations. The beat was at once universal and distinctly my own. The act of placing a stethoscope on another person’s bare chest had always felt akin to a mechanic looking at an engine or a plumber taking a peek under the sink – impersonal, objective, asymmetric. I was always on the outside looking in at an intricate machine, analyzing, critiquing, watching the drama unfold. I had seen hearts stop, hearts cut open, hearts repaired, hearts resume their steady pace.
Lub-dub, lub-dub, lub-dub . . .
But now, with the cold plastic disc laid on my own bare chest, I felt as though I had fallen in. I was at once the doctor and the patient, the scientist and the subject, the healer and the wounded. The fourth wall had shattered, and I suddenly realized I was part of the show all along, just another character in the human drama. I had not been studying medicine for 3 years, I had been studying it for 26. Because medicine is an education in what it means to be human, and we are practicing all the time. For a moment, I saw a piece of myself in every patient and felt a piece of every patient within me.
Lub-dub, lub-dub, lub-dub . . .
Perhaps this was empathy – the ability to feel your patients’ pain as your own and vice versa. Perhaps this was mindfulness – devoting your complete attention to the simple sounds of the present moment. Perhaps this was enlightenment – the understanding that you are small with respect to the universe, yet the entire universe is reflected in you. Or perhaps this was just an ordinary heart.
Lub-dub, lub-dub, lub-dub . .
otherwise unremarkable 