Cases in vaccine court--legal battles over vaccines and autism.

1275 focus on the path of the vagus nerve, not the human being to whom it belonged. Early in our training, bending over our cadavers, we learned to silence a part of ourselves. We learned the power of humor as a means of avoiding hard conversations about more complicated feelings. Often we kept those feelings to ourselves, rarely giving voice to them as we proceeded through far more challenging situations during our clerkships — a newly diagnosed lung cancer, a 2-year-old with an inoperable and therefore fatal brain tumor, a young man with quadriplegia from diving into shallow water. We discussed the medical management and the complications in detail and with intense care, but we could not give voice to the feelings these events evoked, often reducing them, in the formal case presentation, to the single word “unfortunate.” And because we cannot comfortably express these feelings, sometimes we put them away forever or feel incompetent and overwhelmed when we do try to express them. Perhaps if we could discuss this part of our practice lives as easily as we discuss a diagnostic dilemma or the proper management of a complex case, we might create a culture that supports and nourishes us as we try to come to terms with experiences that are part of our daily lives. Being able to communicate more honestly with each other might help us to do so with our patients as well. How different might those codes have felt if, at the end, having declared, “The code is called,” the resident then said, “Let’s have a moment of silence to honor this life.”