Human to human: when doctoring hurts

As physicians, we have to become relatively hardened to the misfortunes of others because if we don’t, we will fall apart.  There is a Ray Bradbury story about the being who would morph into whoever the person next to him lost in order to make them happy and restore what they’ve lost; eventually, too many people needed him, and, overwhelmed, he melted.  It can be like that sometimes when you’re a doctor.

Every once in a while, though, someone just gets to you, the barriers collapse, you stop seeing them as a patient, and start seeing them as a person.  I hate when that happens.

When I was an intern on the Oncology service, I had a patient who had colon cancer; he was in for… something… I don’t recall.  It doesn’t matter.  He was a nice man.  Halfway through his state, he suddenly lost his eyesight – temporarily – as a side effect of his chemo.  He was extremely distressed about that, obviously. He kept saying, “But I’m an engineer!”  His wife was a nurse in the PACU, and she’d come visit him, and chat with the floor nurses.  Sometimes, the floor nurses would cluck their tongues, and say, “Oh, poor Jenny.”  But they did that for any family member.  He was just like any other patient.

Until one night I was going home, dropping off the last of my notes at 6 or 7 o’clock, and I wanted to pop in and check on him.  I found him sitting up in bed, lights off, watching Law and Order, and eating something out of a Glad Tupperware, with a plastic knife and fork.  I said something along the lines of, oh, homecooked meal?  “Jenny made it,” he said. “She knows hospital food isn’t great.”  And he smiled kind of awkwardly out of the corner of his mouth…

That one moment, it just killed me.  I felt such a squeezing, aching empathy? vicarious pain? intense discomfort? that I had to back out of the room quickly to hide my tears. Cried on the T on the way home.  Why? nothing changed; he was still the same patient. Something about that moment, though, where I saw him from a more private, unguarded angle…  It hurt.  I called my mom, and all I had to say was, “Glad Tupperware.”  She got it.

I don’t know what happened to him.  He went home eventually after that admission, at least.  I think he had a liver met, but these days with colon cancer, that’s not necessarily a death sentence.  I don’t know.  I’m glad I don’t know.

I now have another patient, who has a pretty bad illness.  I think maybe he reminds me of a family member.  Something about his profile, but I can’t put my finger on who exactly.  He’s been cheerful and pleasant; he walks up and down the hall with his IV pole, dragging the johnny strings on the floor behind him.  But he’s having complications after complications.  The ERCP that was done to relieve his symptoms made him worse, and he can’t get treated for his original illness because of it.  He said yesterday, when I asked him about his great attitutde, “I know I have cancer. But I don’t feel like I have cancer.”

I suddenly felt that very same pinch and ache.  And I just don’t think I can deal with it today.  My heart can’t take it.

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