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The Things We Carry

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.

The load on my shoulders feels heavier these days. Since the pandemic began, I have lost thirty-five patients in the retirement community where I work. These are the people I see more often than anyone else in my life, other than my immediate family.

The things we carry.

The woman who playfully let me borrow her Harry Potter glasses so that I could begin to perfect my Professor Trelawney costume for trick-or-treating with my kids.

The man who had lovingly devoted himself to his wife, who had dementia, now being cared for in his final moments, nearly a decade later, by the same nurse who had brought dignity to his wife at the end of her life.

The wife who met her future husband when he walked into the wrong ceremony at the venue where they both were attending different weddings. They walked in stride during their seventy-two-year marriage.

The mom whose daughter, knowing that it was the hardest thing she would ever have to do, left to fly back to the West Coast, just days before her mom died.

The daughter who did not leave her mom’s bedside as she lived her last days, because her mom had lain in bed with her every night when she’d gone through cancer treatments as a child.

My oldest patient who ever successfully quit smoking, at age ninety-eight. For her last birthday, I bought her some candy cigarettes, and we shared one last “smoke.”

The woman whose family, in her final moments, during the earliest weeks of the pandemic, gathered outside of the window of her nursing-facility room, while the staff moved her bed in front of it so they could say goodbye.

The wife whose husband penned a last love letter to her less than a week before she died from COVID-19, while he too battled the virus: “My life is in suspension until we are together again.”

The things we carry.

The loss is heavy, but with it have also come positive indelible marks–the connection, the humor, the wisdom, the advice.

One patient taught me the “ABCs of life”: “Always Be Curious.” My children hear me say that now.

Another told me, “In marriage we are more welded than wedded.” Also, “When you are fighting, ask yourself if you are fighting for yourself, or for each other.” I try to remember that advice when my husband and I have a disagreement.

And “When your children accomplish something, be happy for them. Not proud. Pride implies there is something you did to impact the outcome. It is their achievement.” Those words humble me.

The things we carry.

The backpack. Heavy with sorrows, beauty filling the in-between. Not the kind of backpack with so many compartments that it’s hard to remember where you put your favorite pen. More like a duffel bag where everything is thrown into one place, all the contents mixed. The hardships and the blessings. The individual contents are impossible to separate; they shape the character of those who carry them.

Picture duffel bags so heavy that lifting them requires a person on either side, each holding a strap. That is the teamwork of medicine. The ultimate team sport. We never carry the load alone.

In long-term care settings, the doctors have more name recognition, but the heroes–the souls who do the heaviest lifting–are the nurses and the certified nursing assistants. They are tireless. Administering medications, transferring patients into and out of beds and wheelchairs, bathing, incontinence care; they do it all.

I asked one how she does it. After all, there are patients with cognitive impairment who are impulsive, violent, uncooperative, wide awake all night.

“I give everything I have when I am here. And then when I go home, I leave it,” she told me. “I am a big basket that is put in deep water, but when you pull me out, all the water escapes, too.”

Every one of us can see ourselves in these stories. Are you the daughter, the husband, the wife, the widower, the healthcare worker or the eventual patient?

What if the pandemic is just the greatest, most recent reminder of the responsibility that we all have to carry each other?

What can we do to lighten each other’s load?

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Danielle Snyderman is an associate professor and geriatrician in the department of family and community medicine at Jefferson Medical College in Philadelphia. She coedits the college’s Eakins Writers’ Workshop and Evanescent literary journal, and serves as the medical director of a continuing-care retirement community. “I consider myself a story collector and believe that knowing my patients’ stories helps me to take better care of them in a way that is consistent with their values. My year-long project interviewing my patients about their most important love relationship appeared in The Philadelphia Inquirer in 2015. I find that writing is not only an avenue for patient advocacy but is also a form of self-care.”

Comments

30 thoughts on “The Things We Carry”

  1. I have been a Pulse reader for years and this is by far my favorite essay. I especially liked that you included some of the wisdom you learned from others.
    I worked in long term care and rehab for 6 yrs before moving to home visits with Palliative Care. I forwarded this to my old team and they really enjoyed it. I think it provides a sense of validation.

  2. Well written and very meaningful. Working in pediatrics in a developing country and losing many neonates, this resonates so much. Thanks!

  3. Such beautiful words. Indeed, the lessons we learn from patients enrich us in ways we couldn’t have imagined!
    Thank you for sharing these stories and for being such a thoughtful, caring and compassionate physician, friend, and advocate.

  4. I am a retired registered nurse and read the Pilse every week or more if there are extra issues.
    I found this to be one of the most meaningful compositions to me.
    Having worked in home care for so many years, we too develop very strong relationships to our patients and their families.
    Thank you for sharing this.
    Geoff Bradley

    1. danielle snyderman

      Thank you Geoff. Seeing your patients in their homes, surrounded by family, adds so much to the relationship.

  5. Beautiful. I love the snapshot stories you shared about your patients. Caring for them is a tremendous privilege. And it is so humbling. Thank you for sharing yourself with the world

  6. Thank you for your humanity, Danielle! Pausing to read these beautiful thoughts enriches our practice, and our lives.

  7. Ashrei Bayewitz

    Really great. Loved the title and the story. Captures the spirit of much of our work.
    Shared it with the rest of the Heme-Onc division at our hospital.
    Thank you.

  8. Wonderful, touching reminder of the hard work, dedication, commitment, caring, and love that those in healthcare provide to such a vulnerable population group, and those that find themselves needing their temporary care, particularly now, during the pandemic. Well said!

  9. Yes, well written. I am a long term cancer patient. I witness first hand the emotional hardship that nurses endure and the things they carry. Thank you for advocating for those working in health care.

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