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Twenty Children, Six Teachers, Two Sets of Eyes, a Dog, and a Transformation

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Twenty children, six teachers, two sets of eyes, and a dog were a terribly tragic catalyst for my metamorphosis as a physician and person. Let me explain. Until the cataclysmic event, I was an academic physician at an Ivy League institution who worshipped at the altar of evidence-based medicine and thought housestaff and students should supplicate alongside me. If a physician were to affect a change in plan for a patient, I demanded they knew the evidence to support the intervention, especially when there existed what I considered to be a landmark study. It was as if I had a secret love affair with acronyms: TIMI, CAPRIE, ALLHAT, 4S, and so forth, and my learners rewarded me and reinforced this practice with glowing evaluations.

But then on a mid-December day a little more than 5 years ago something happened, something so heinous and vile that it will always be one of those things you’ll remember where you were when you heard about it, like where you were when Kennedy was assassinated and where you were on 9/11. That’s the day when a gravely mentally ill young man entered an elementary school, Sandy Hook Elementary School, in our idyllic rural Connecticut town that we called home for 20 years, and robbed the world of those educators and innocent elementary school children in one of the most deplorable acts in American history. He was a classmate of my son.

Newtown is a small town, one where we run into one another at the diner, or the general store, or Ferris Acres farms, home of what has to be the best ice cream in Connecticut. If you’re in the area, I highly recommend the Moose Tracks or the Bada-Bing in a waffle cone. You can add sprinkles for a nominal charge, if you like.

Although my children were not directly involved in the massacre, because it is a small town, we knew so many who were directly affected: teachers at the school, some who heroically saved children, parents who received calls summoning them to the firehouse to find out their child’s fate, physicians summoned to the emergency department to await children who never arrived, and yes, someone who lost her precious son, Noah.

It was at his family’s Shiva, a Jewish ritual of mourning, where I stumbled to find a few impossible words of solace for a grieving mother when I encountered those eyes, the tortured eyes of a mother who had innocently sent her son to school one morning and never had another opportunity to hear his laugh or feel his loving hug. Her faraway eyes told a story of dark despair and unimaginable, unrelenting pain.

Those eyes and her pain haunted me long after I left the home. I saw them at night when I tried to sleep, I saw them when I watched Anderson Cooper interview friends and neighbors on TV, I saw them as the incessant news trucks rode through town, I even saw them when I was with patients. During the ensuing days, I cried every day; often sobbing, shoulder-shaking, nose-running cries. By day, I went to work. I was there, for sure, but I was certainly not present. When I walked the halls of my Veterans Affairs hospital, my second home, I could not look anyone in the eyes when I passed them. While normally I walk the halls looking to greet or interact with anyone I pass, during this time, the floor seemed a much more hospitable place to entrust my gaze.

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-Daniel G. Federman, MD

This article originally appeared in the September issue of The American Journal of Medicine.

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