My dad was once a physician for the coal mines in Yorkshire, England, where I grew up. It's been decades since I accompanied him on his rounds, and fifteen years since I moved to the States and began to practice as a physician assistant in the Appalachian Mountains of North Carolina. But I still vividly recall my childhood days and the Yorkshire dialect we spoke.
Somehow, the seventy-three-year-old woman sitting in my exam room takes me back to that time.
She's coughing violently--hacking thick yellow mucous into her tissue, spraying the floor with spittle--just as my father's patients did.
The minutes dragged. She worked at it--
sweat pooling in her frown, her lungs
bellowed in and out as if the air were oil.
Her expression never changed.
Beneath the light,
my mother's skin looked violet.
I squeezed her hand,
pressed her fingertips, stroked the branching veins,
but...nothing. And so, good nurse,
I held her wrist between my fingertips and counted
one, two, three. Then the last beat came
just as light travels from a star
Marc D. Wager
When I was in medical school, more than thirty years ago, I felt I received pretty good training on how to communicate clearly and effectively with patients and families. I even remember the name of the fictitious character we had to practice telling about his wife's demise: "Mr. Gottrocks, I'm afraid that your wife has taken a turn for the worse; I think you should come to the ICU right now." As a pediatrician, more recently, I've been trained to discuss vaccines in a nonjudgmental way with parents who, contrary to my wishes, decide not to vaccinate their children.
Despite all of this training, though, and despite many articles on the merits of doctors admitting their wrongdoing, nobody ever taught me how to say, "I'm sorry, I think I screwed up."