I can’t stop thinking about you.
Last night, at about midnight, the phone aroused me from my happy slumber. It was Vance, the on-call resident, needing advice from me, as the supervising physician, on how to help a worried mother—you—who’d called our family health center’s after-hours service about your daughter’s worsening asthma.
It was March 2020, and COVID was coming. The virus hadn’t yet reached my small suburban community in Pennsylvania, but already businesses were waning, streets were emptying, clinics were closing. Fear was widespread.
A collective refrain sounded: “Shut it down”—the university, the restaurants and, most of all, the public schools.
The last time I had alcohol was on a blustery night in February of 2020, right before my college-age son’s musical. I’d traveled from Los Angeles to his rural Ohio college campus, and I drank two glasses of cheap chardonnay in the college café with its burgundy walls and snug booths.
“He basically killed me,” Sam said flatly, sitting my office. “I don’t want to talk to him.”
I nodded sadly with understanding as his on-demand oxygen hissed away each moment, like the ticking of a clock. Why would a patient want to speak to a doctor who’d missed his diagnosis? Why should he?
I heard him coming before I saw him.
Kerflop…kerflop…kerflop….
The sound grew louder as a pale, gaunt man in a red Toyota pickup truck pulled into our clinic’s lot. He parked in front of the window where I was seated.
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.
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.
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.
Seventeen years ago, I was a senior psychiatry resident, moonlighting on weekends in the psych unit at a small rural hospital. Usually the unit was quiet. In this remote corner of northern Canada, we were taught to value resources and avoid “unnecessary” psychiatry admissions.
Arriving one rainy Friday, I headed to the ER to let them know I was there. Among the mostly frail, elderly patients, one person stood out: a healthy-looking woman in her early thirties, about my age.
I keep having this dream where I’m trying to call 911, and I can’t. I can’t seem to get the phone to work. I become panicked, and I can’t breathe. My heartbeat pounds in my ears, and I feel the sharp taste of bile in my throat.
When I wake up, that shaky feeling of fear and impotence clings to me. I don’t ever remember what was wrong in the dream–why I needed to call 911. I just remember not being able to.
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