Grace Glassman took the mic. A 56-year-old emergency physician, she launched into a story of the day she was preparing to do a rare and gruesome procedure called a lateral canthotomy.
The patient was an intoxicated male who had tried to hang himself with his bedsheets the previous night. Now he had a bloody mass behind his eyeball. “If people are squeamish, I suggest you get your AirPods out, put them in and you turn up your music now,” Glassman said. “Don’t say I didn’t warn you.”
Nine doctors were gathered at a Brooklyn Public Library branch in Fort Greene on a Saturday night to tell true stories at an event called Airway. All work in Brooklyn at Maimonides Health, most of them in the hospital’s emergency room. They were taking the night off to try to talk honestly about the pride and occasional inadequacy they felt in their work. In concept, Airway is like the Moth — ordinary people telling everyday stories — but with all the vérité drama of HBO Max’s scripted E.R. show “The Pitt.”
Glassman continued. The lateral canthotomy — a cut, then a probe and snip under the skin at the outer corner of the eye — would save the patient’s vision. If done correctly, the eyeball would “not come, like, out out, like roll off the table,” she said, with a canny smile. It would merely relieve the pressure on the optic nerve by loosening the eyeball in its socket. The audience — doctors intermingled with members of the lay public — laughed uneasily.
This physician wanted to convey the mounting stress she felt to the 150 friends and strangers packed into the hot, bright room. An E.R. doctor for 20 years, she had taught the lateral canthotomy to residents by PowerPoint but had never performed one herself. With 90 minutes to spare until the patient lost sight in one eye, she prepped by watching YouTube videos. “I’m not a cowboy like a lot of my colleagues,” she admitted. “And I do not like these big, high stakes, bloody, messy, risky procedures.”
A terrifying imbalance lies at the heart of every doctor-patient relationship: The doctor can ask practically anything about the patient. Pain, marital status, ability to pay. Frequency of sex, weight, suicidal thoughts, alcohol and drug use — prescribed and illicit. The patient knows almost nothing about the person in the white coat, yet is expected to trust them with their health and, sometimes, their life. As Nakesha King, an attending physician in trauma surgery, pointed out when she took the stage, she’s the one holding the scalpel. The patient is asleep. “How much sense does that make?”
This was the second public Airway event, one aim of which is to address the widespread mistrust of doctors by showcasing physicians not as godlike figures, but as real individuals with preoccupations and triumphs, insights and anxieties. The dangers inherent in a project like this are self-evident: Can physicians express their foibles without endangering their authority or undermining trust in the skills and instincts they’ve worked years to master? Or is trust earned through a mutual exchange of vulnerability and hopefulness?
Josh Schiller, a 57-year-old emergency room physician and co-founder of Airway, said he hopes such events will rationalize people’s expectations of doctors. “We are confident practitioners, but we are not perfect,” he said in an interview. In his introductory remarks, Schiller addressed a 7-year-old girl who was in the audience with her mother.
“I want you not to be afraid to go into a hospital and see a doctor who has a white coat. I know I look scary, but I’m really not,” he said, wearing a black T-shirt that said “I 
NY.” Because we have real emotions and we have real lives beyond what we do.”
A High Burnout Rate
Airway started informally about a decade ago as a teaching tool. As an assistant professor of the intro to clinical medicine course at SUNY Downstate, Mert Erogul, who is 55, was seeking ways to counter the “hidden curriculum,” as it’s known in medicine.
Medical students enter the classroom idealistic and motivated. Then, in the hospital, they get an education in “the dysfunction, the cynicism” of hospital medicine, Erogul said in an interview. Erogul happens also to teach literature in medical school, believing that immersion in Chekhov and Lorrie Moore can help students build empathy.
He began inviting fourth-year medical students to a bar to tell their own stories — “totally informal, with drinks” — and found that when they felt safe to talk freely about the hospital experiences that mattered to or troubled them, “they didn’t tell cynical stories about, ‘Oh, I hate the patients and this sucks,’” he said. “They would always reach for these elevated ways of reframing their experience.”
At the Maimonides E.R., Erogul, Schiller and a third colleague, Arlene Chung, formalized storytelling nights as a way to create camaraderie and a positive culture. According to the American Medical Association, E.R. doctors have the highest rate of burnout — 57 percent — of all specialties.
Airway began to circulate nationally as a professional development tool, an icebreaker at emergency medicine conferences and an empathy exercise in teaching hospitals. In 2020, it was on the agenda at the annual meeting of the New York chapter of the American College of Emergency Physicians, which took place on Zoom. In his story that year, Schiller described the eerie silence in the E.R. at the beginning of the Covid-19 pandemic. With everyone masked and patients breathless or intubated, no one spoke. One night, in the middle of the night, an elderly patient with dementia found enough oxygen to sing.
She was a former opera singer. “At first people couldn’t believe they were actually hearing it,” Schiller recalled in an interview. “Maybe it was like someone had flipped on a radio.” And then everyone on the floor realized it was coming from the critical care unit, and all the practitioners ceased work. “For five minutes all you could hear was this aria, and it was soaring above us. In this place where no one would ever imagine such a thing.”
It’s one thing to sit in a dark bar with a dozen or two trusted colleagues. It’s another to stand up under bright lights with a mic and a 5- to 7-minute time limit, under pressure to be entertaining. Before the show Glassman spoke of how much she loved “The Pitt.” “We all strive to be a little like Noah Wyle,” conceded Glassman. “He’s aged and matured so well.”
Erogul told a story about a world-famous cardiothoracic surgeon who in the operating room had tied a student, a grown man, to an IV pole with surgical tape as punishment for having made a mistake. Two residents spoke on the theme of unlearning their naïveté. One described his disappointment that he could not help a 99-year-old patient he admired reach his 100th birthday. Another talked about believing beyond reason that she could assuage a daughter’s grief at the imminent death of her mother.
Schiller told about the recent time he was speeding to work, running red lights in his car. Before being pulled over by police, he was telling himself a self-justifying tale. Thanks to his determination, he would arrive promptly and relieve an exhausted colleague who had worked overnight. Schiller seethed by the side of the road as a police officer wrote a ticket. Handing it to Schiller, the officer left him with a parting remark. “You know what? There were people who died on this street a couple days ago,” he said.
In that moment, everything shifted, Schiller said to the audience. The young officer’s scolding jogged his memory: He had been working when those accident victims were carried in. “I saw those people,” he said, his voice full of self-recrimination and rage. “And there was more than one. And a lot of those people were not adults.” As the officer was walking away, Schiller called to him. He was a doctor, he confessed. “I deserve this ticket. I mean, look what I did,” he said.
Kim Davis was in the audience, listening. A friend of Schiller and Erogul and a psychotherapist whose focus is grief, she reflected on the therapeutic effect personal storytelling can have on the doctors. “Doctors can be put on pedestals or they can be the object of a lot of scorn,” she said in a call. With his story, Schiller “realized he was fallible” and a roomful of others witnessed that moment of self-discovery.
Glassman didn’t have to do the lateral canthotomy after all. Just as she was summoning the courage to slit the patient’s eyelid, then reach into the space behind the eyeball with scissors and snip the tendon that held it in place — “like a guitar string,” she said — the trauma ophthalmologist on call phoned in. Having looked at the scans, the consulting doctor didn’t think the procedure would be necessary. In her amped up state, Glassman snapped. “You don’t think? Or you know?”
To Glassman’s relief, the patient was transferred to a specialist’s care. But the next time she is faced with a lateral canthotomy, Glassman concluded, she will be prepared. And fearless. “I mean, we’re human beings and all that. But we are very on point when a moment like this comes up,” she said.
Lisa Miller is a Times reporter who writes about the personal and cultural struggle to attain good health.
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