Last patient of the day, and of the work week! I was finishing what felt like my Thursday Night Endurance Test, after which I could go home to my family, and eventually to bed.
As on so many Thursdays, I was running behind. My final appointment was with a new patient, Ann Miller. Before entering the exam room, I did some fact-finding.
The exam room bears an odor; it’s a musty sweetness, not unpleasant, but one that I know well–fetor hepaticus, a sign of severe liver disease.
My patient, Ms. Atkins, slouches on the exam table, brooding. She’s thirty-four years old, and an alcoholic. She is joined by her mother and her five-year-old daughter, Mari, who skips to my side, long braids bouncing off her shoulders.
“As I hang up my uniform, she will put hers on,” my uncle proudly told my aunt when I announced my plan to attend medical school under the auspices of the US Air Force Health Professions Scholarship Program.
Two of my uncles had illustrious Indian Army careers–one as a brigadier general and the other as a lieutenant colonel–but my own military potential was less obvious. I was a stereotypical “girly girl,” a flop in sports and the last one picked for any team in gym class. So when I told people I was joining the Air Force, the reactions were amusing.
One morning, in the women’s ward of a semirural hospital where I was working as a family-medicine resident, my team encountered a rarity: a disabled forty-year-old lady with crutches. Her case seemed to scream for attention, and I made my way to her bed.
“I’m really sorry,” the audiologist said. From her expression, I could see that she meant it.
It was the winter of 2012, when Barack Obama and Mitt Romney were about to become their parties’ nominees for president, and the case that would legalize same-sex marriage was on its way to the Supreme Court.
It has been said that we in health care carry a backpack of sorrows.
There is a sanctity to being on the inside, trusted to care for people in their weakest, darkest and most vulnerable moments. When it feels like control is gone, we steady our voices even when we too feel scared.
I was twenty-eight when I first walked into Matthew’s room in the neurosurgery ward at the university medical center. A newly graduated physical therapist, I was working at my first job in the field. I was there to evaluate Matthew for physical therapy, and I had all the right gear–a white lab coat, running shoes, a stethoscope, a clipboard and a goniometer (an instrument that measures joint angles)–and an enthusiastic desire to help this young man function normally.
Oncologists like myself are no strangers to death. It is all too familiar. We give our patients the best that medicine has to offer; we cure them if we can. When our efforts fail, we relieve their pain and ease their suffering. And when they pass away, we grieve. With their friends, colleagues, family members, partners and spouses, we grieve.
Almost by definition, a time of mourning is a time of gathering. Both to grieve and to console, we must be present with one another. I try to be there for my patients and their families and to answer all of their questions with candor and concern.