Posts tagged patient

Cancer Family by Nancy Borowick. (republished with permission)

The burden of cancer does not fall upon just the individual, but also upon the family and friends who support them. It is this shared experience that is so important yet often missed in the cancer narrative. We must always consider how everyone else is surviving this diagnosis.

Nancy Borowick’s mother had been fighting breast cancer for nearly 20 years when her husband was diagnosed with pancreatic cancer. They underwent treatment together for a year before he succumbed to his condition.

She sought to document the pain and the challenges they faced in this time but also their strength and their courage together, “from the daily banter they shared as husband and wife to their shifting dynamic as patient and caregiver.

"Cancer gave my family a harsh yet valuable gift: an awareness of time."

Nancy continues to document her mother’s day to day life, from the grief of losing her husband to the strength she finds through her family and friends. For instance, Nancy’s brother-in-law, Paul Flach from the UK, has also lost his father to cancer. He is running the Berlin Marathon this September as part of the UK Institute for Cancer Research fundraising team.

That Horrible Feeling

When you see patients with scabies or pink eye and you feel the creepy crawlies just itching under your fingers and eyes for the rest of the day.

There are two important events in your life: your birth and your death. One is already finished; for what is left, I expect to live mine to the fullest.
A terminally ill patient’s outlook on the remainder of his life.
This food tastes like ash!
A patient’s review of hospital food. 

I Do Not Fear Death by Roger Ebert

"I will pass away sooner than most people who read this, but that doesn’t shake my sense of wonder and joy."

The essay is from Roger Ebert’s Life Itself: A Memoir and was published to Salon as a memorial of sorts for a recently deceased critic and friend. It is a beautifully written essay about that final threshold to which we all find at the end of our days.

He Who Inspires…

Recently, I had the great pleasure of working with a specialist. While I found him to be an excellent doctor and teacher of his field, he impressed me more with his mastery of the art of medicine.

Watching him work reminded me of the heart it takes to work with patients.

After spending a morning with him, I can honestly say without hesitation: I have never been more inspired about medicine.

There was nothing complicated or mysterious about his interactions with patients. There was no parlour tricks or unnatural question structure. It was just him, his patient, and the problem. His language was simple, his examples relevant, and his explanations honest. 

We often talk about empathy as a tool to help us connect to a patient. In my hands, it is an embarrassingly clunky, yet unrefined hammer of “it must be frustrating,” or that “I see you are upset.” His was the precision cut scalpel that sliced to the core issues and emotions. 

Patients simply opened up to and connected with him. And I, sitting in my seat, even felt the transference of emotions at times as well. It was a powerful and beautiful display of the art of medicine at work.

To his patients, it was an overwhelming sense of feeling human in the eyes of a stranger, to not feel like a bag of meat at the mercy of a probe and a blade. To him, it was just the way medicine had always been and would continue to be.

For me, it was the revelation of what it is to truly practice great medicine.

The Everyman Patient. 

Almost every day, I see a patient that has such a large spectrum of co-morbidities that to consolidate the information neatly and concisely is an undertaking in itself. There are patients who have allergies or complications to most of our treatment medications, leaving us few options. There are the frequent history or physical findings that do not match up with my attending’s findings. And yes, there are fall risks. 

This is a small sample of the common trends I see on the ward but you know, with a bit more tongue-in-cheek humour.

The Michael Jackson Drug

  • Anaesthesiologist: Alright, it is time to put you to sleep.
  • Patient: Sounds good.
  • Anaesthesiologist: And here comes the Michael Jackson drug.
  • Patient: *Laughs*
  • Anaesthesiologist: This is propofol. You will feel a sting.
  • Patient: I do not mind a slight sting but will I wake up after?
  • Anaesthesiologist: Of course. We are not letting you off the hook that easily.
  • Patient: Ha! Very well. Proceed.
  • Anaesthesiologist: Sweet dreams.

Not on my White Coat

  • While doing a physical on a volunteer patient, noticing he could not keep still.
  • Me: How are we doing here, sir?
  • Pt: Not so good. I think that stomach upset from this morning...I think it's back.
  • Me: Back?
  • Pt: I think I'm going to throw up.
  • Me: ?! Hold on, let me grab the bin for you.
  • After a vomiting bout, the patient starts to feel an urge to use the washroom. With some help from a nurse, we help him out but were unable to reach the washroom after he becomes dizzy. A doctor passes by and notices.
  • Dr: Whoa, what's going on here. Sir, are you okay?
  • Pt: I don't know, I really don't feel good.
  • Dr: We should get you checked out just to make sure you're okay.
  • While the patient is put into a bed and taken to the emergency department, my tutor returns.
  • Tutor: Tom...what did you do?
  • Me: Um...
  • Tutor: I said take a history and physical, not send him to the ER.
A well person is a patient who has not been completely worked up.

A resident’s answer to the question: what is a well person?

Clifton K. Meador, MD. The Last Well Person. New England Journal of Medicine 1994, 330(6): 440