"Bugle Notes" - "Breathless Expectation"

I read something recently in which the expression “breathless expectation” was used. It describes how a person should feel about not knowing what tomorrow may bring. This caused me to think about the last time I experienced what could only be described as a time of “breathless expectation”.

The memories began flooding back! “Breathless expectation” could easily describe the interminable wait until my next baseball game in my playing days but especially Little League! It was pure torture! I would have my uniform on and glove ready to play hours before game time! Christmas! My older brother and I absolutely could not sleep Christmas Eve our excitement and anticipation was so great! Then there were the almost yearly “new kid in school” routine that I experienced as an “Army Brat”. The expectation the night before was probably best described as anxious excitement yet the unknown was still there. It was not fun being the new kid.

As time went by, these experiences became more significant. The day before I entered West Point at the age of 17 is etched in my memory as if it happened yesterday! I thought I knew what to expect that first day but I quickly found out I had no clue. It was immeasurably more difficult than I ever imagined. Four years later, after much blood, sweat, and tears, graduation day came and the expectation of that day truly took my breath away. Two weeks later came the marriage to my wife, Cathy, of now 40 years! This was followed by my first assignment in the Army in Germany, then my acceptance to medical school, first child born, graduation, starting residency, completing residency. The most vivid memory, though, was the night before I deployed with the 101^st Air Assault Division to Saudi Arabia for the First Gulf War. It was and remains the worst day of my life, leaving Cathy and my 3 young sons not knowing what was going to happen or when and even if I would return. That night before I left, Cathy and I laid in bed holding each other and crying. It was painful.

What were the times in your life that you would describe as “breathless expectation”? A more pointed question, though, would be, “When was the last time you felt this in medicine?” I would bet that early in your careers this experience was not uncommon – first day of medical school, first patient interview, first blood draw, IV, case presentation, start of residency, beginning clinical practice. Do any physicians, or for that matter, any health care provider, experience this anymore once the “newness” of medicine wears off and the daily grind of medicine begins?

Wouldn’t it be great to experience that feeling again? To have so much excitement about what tomorrow will bring that we are breathless with expectation – we can’t wait for the next day to come! Many would say that’s no longer possible in today’s chaotic, unpredictable, volume driven culture that is health care. The optimistic side of me disagrees. I believe you can have those moments but only if you will take the time to step back, reflect, and remember why you chose medicine, why what you do is  important, and that you make a difference in the lives of people every day. The sacred relationship between physician and patient is the catalyst to again have those times of “breathless expectation” that once kept us awake at night with excitement and anticipation.

You are appreciated and valued more than you know.

Andy Lamb, MD