As I walked into the room, I see my patient lying in bed, eyes closed. His wife of 50-plus years sat in the recliner next to him grasping his right hand. The holiday season was upon us. My patient has spent the better part of the last month in the hospital.
His wife was staring at the pretty scenery outside with her weary, tired eyes. It had started snowing this morning. Tiny snowflakes were falling onto the ground creating a delightful pattern all around.
It was not so nice inside. My patient lay on the bed with a gaunt look on his cheeks and evidence of his 60-pound weight loss the past three months visible on his light frame. He was jaundiced.
I had the patient’s pathology report in my hand. The news was not good — stage 4 pancreatic cancer with spread to the common bile duct and liver. I nodded at his wife and was going to return later to tell him the bad news. His eyes fluttered open and with a weak smile on his face, he said, “Hi doc, how are you today?”
I took a deep breath and sat down on a folding chair next to the patient and his wife. Working in hospital medicine, I deal with patients who are grieving, angry and feeling hopeless. Often, I am the first person telling them of their new cancer diagnosis or calling a loved one to tell them of their mother’s severe cardiac arrest is not survivable and that they should make arrangements to get here ASAP. It doesn’t get easier the next time around
I explained the findings in lay terms to the both of them. His wife sobbed quietly. I handed her a tissue and hugged her. As I stood up with unshed tears in my eyes, my patient held onto my hand with a stronger grasp.
“It’s OK, doc. We now know why I am so weak. Why I can’t eat. We all die one day. I want to go home.” His wife agreed.
I promised him we will make that happen. Never mind it is the holiday weekend and no hospice agencies will be open. No medical transport will be available until Monday — which will be five days from now. I wrote scripts for pain medications and anxiety medications, and our case manager got those filled at the hospital.
His wife gathered four friends who came and helped transport him home in the back of an SUV. “We will carry him into the house,” they promised.
Three hours later, I waved goodbye to him in the hallway as the transport team helped push him on a stretcher out to the parking lot. Knowing this will likely be the last time I will see him. Although I am not his primary care doctor, I felt we had a connection as I had taken care of him multiple times the past five years in the hospital.
“Thank you, doc, for everything you did. I appreciate it.”
A week later, I received a card from his wife telling me of his peaceful passing at home surrounded by his loved ones and thanking me for fulfilling his last wish.
As we approach this holiday season, it reminded me of how lucky we are to be able to make a difference in the lives of those we encounter in our daily lives — no matter what we do and who we are.
I remember being on the receiving end of this many times as well.
I was in my ninth month of pregnancy and working my third evening shift in a row. The computer system crashed two hours ago. We were frantically pulling out old paper orders to write. Labs were printed on paper which had to be manually retrieved from the lab office and brought to the emergency room (ER) where I was. Six more patients were waiting to be admitted in the ER, which is now at full capacity with another 15 patients in the waiting area. I looked up at the clock and realized it was 8.30 p.m. The cafeteria closed 30 minutes ago, and I had not had any dinner yet. An ER nurse heard my gasp and asked what the matter was. He came back shortly after with a freshly made grilled cheese sandwich and a piping hot cup of hot chocolate.
Although we aim to make a difference year round, the holiday season is a good time to start thinking of making more of a difference.
The world is going through a lot of turbulence with the uncertainties surrounding the Korean Peninsula and threats of nuclear war on an international front, several mass-casualty shootings in the United States within the past few months, and the high level of homelessness and lack of warming shelters in the town I live in.
In the midst of the evils around us, let us all make a difference, one step at a time.
I have no defined number of acts of kindness to get to this year, but I do consciousness “be kinder” to all.
“Foreign BornMD” is a physician who blogs at her self-titled site, Foreign Born MD.
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