When does a person become a patient become an organ or a thing - a gallbladder, an amputation, a diverticulitis? The onset was so insidious that I never even noticed the progression, especially on surgery where everyone becomes that which we operate on. When did I stop noticing the person and, to some degree, stop caring? This was not what I came to med school for.
I recently observed a family meeting with the patient, his wife, and their oldest son. The patient was terminal, his death is only a matter of time; the only surgical intervention left would mean certain death. For the first time in weeks I saw not the blank yet pained gaze through lidded eyes still heavy with sleep at 5:30am, but emotion: sadness, contemplation, and reflection. I saw not a patient who we monitored through labs, changed wound dressings on daily, and examined with the repetitive motions of a machine; I saw a father and a grandfather who, though saddened by the inevitability of his end, is without regret for living his life.
His wife asked with tears obscuring her eyes, "Can you give us a time estimate of how long?" We had no answer - it could be hours, days, weeks, months. With diagnosing complete and treatment deferred, true healing can now begin. As for me, I can start caring again and do what I came here to do.
I recently observed a family meeting with the patient, his wife, and their oldest son. The patient was terminal, his death is only a matter of time; the only surgical intervention left would mean certain death. For the first time in weeks I saw not the blank yet pained gaze through lidded eyes still heavy with sleep at 5:30am, but emotion: sadness, contemplation, and reflection. I saw not a patient who we monitored through labs, changed wound dressings on daily, and examined with the repetitive motions of a machine; I saw a father and a grandfather who, though saddened by the inevitability of his end, is without regret for living his life.
His wife asked with tears obscuring her eyes, "Can you give us a time estimate of how long?" We had no answer - it could be hours, days, weeks, months. With diagnosing complete and treatment deferred, true healing can now begin. As for me, I can start caring again and do what I came here to do.
6 comments:
It does seem bad to refer to people by their diseases, etc. But it's really just a shorthand. Instead of saying "Mr. Phillipousis," to which someone will inevitably reply, "Which one is he?" and you have to say, "The man with diverticulitis," you shortcut the conversation, since time is precious, and you say, "The diverticulitis." You leave out "patient with," because it's unnecessary — of course you're talking about a patient: it goes without saying.
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Yes, that's true, but when even in the back of your head they're just a condition rather than a person, than on an individual level I find it disturbing. Then again, that's also the nature of some specialties - some are more personal and some are more detached.
I enjoyed this blog posting Aek...I'm glad you've decided to become a doctor. Your empathy and kindness shows in the careful thoughts you post on your blog. I wish we had more doctors like you aspire to be in the community now. Have a great week ahead!!
Aek: Please never lose your humanity and compassion. Doctors like you make the best kind of physicians. Altho I can see why you have to guard against getting too involved with your patients, don't get lost in the bureaucracy of insurance forms and hospital rules.
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