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The TCBM Moment

My Associate Dean uses a phrase to describe the experience of a medical student realizing their humanity in relation to the humanity of a patient in a difficult situation: The TCBM Moment. TCBM is not medical jargon; it simply means "that could be me." It is a sudden and powerful burst of empathy that can often be terrifyingly painful. I myself haven't had one in quite some time. There is a tendency to become numb to sickness and suffering when you think about if from the weeds virtually every day of your life, for self-preservation if nothing else.

A woman and child in the "sick people area" in Sierra Leone (Image: BBC News)

I then watched this short piece about an Ebola-stricken village in Sierra Leone from the BBC, as recommended by Dr. Heather Lander via Twitter (@PathogenPhD). Bam! There it was: a TCBM Moment. Oh don't get me wrong: I'm not frightened that I will suddenly develop Ebola. This was much more visceral (no pun intended). Without diminishing the video's impact, I'll just say that there is a moment when a mother has a child who has a headache. Is he infected? Who knows? Should he be sent where the sick people are to protect the others? What if he just has a headache, and then becomes infected when he initially wasn't? One thing is virtually guaranteed: if he goes, he will die. Would she, as his mother, stay with him while he develops Ebola and dies, or should she stay with the other children? If she goes with the first, she herself would likely become infected and die in the end, leaving the others alone. If she does not, she is sending her little boy off to die alone. I sat at my desk and cried, because it was such a gut-wrenching moment. How does one make such a decision? I have two sons. I do not know, and I hope I never find out. Would I go with the sick one and abandon the healthy? Would I send the sick one away to protect the healthy one's chance at having some semblance of a family intact? I don't know. To the woman in the video, I would say this: I am sorry. My tears do not help you, but I'm sorry. By a favorable turn of chance, I was born in a Western country and my boys are safe. Our experience is new, but it seems that we rarely die of Ebola here. Our medical interventions involve low tech, labor-intensive treatments. In other words, there is no reason that so many have to die, if we would support your treatment adequately. We can do better. In another life, you could be me and I could be you. I owe it to you to do better.

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