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Caring for sick patients in hospital is what I do. I am an internist, a doctor that specializes in taking care of adults with complicated medical problems. I love my work. But, like many of us, I have become tired during these past 12 months. The work has been harder, the hours longer and my usual compartmentalization of leaving work at work has been impossible.
Not so long ago, I was reminded of the power of human interaction. Community is what we are all missing. Fleetingly, we try to recapture this with virtual platforms and grasp at this, often unsuccessfully, from behind layers of personal protective equipment.
I was on call caring for patients in the midst of the second wave of the pandemic. No visitors were allowed in the building. Of course, the downstream effect of this was my patients were uncomfortable, scared and alone. Prior to leaving for the evening, a CT scan was completed and its findings were unexpected and unfortunate for my patient. I decided to disclose the news to him that night prior to leaving.
The nurses had gathered in pairs for shift change, leaving the halls empty. The ward was eerily quiet. The occasional and intrusive beeping breaking the hum of flowing oxygen. In what had become ritualistic these past months, I took off my white coat and hung it outside his door, replacing it with a yellow gown. Cracked hands long dried by frequent sanitizing were gloved. I rechecked the fit of my mask and goggles before entering; my humanity safely tucked away from an invisible scourge. I took a deep breath and walked in.
He looked uncomfortable lying there in his bed. Wincing, he shifted his weight onto his right hip to make better eye contact. His oxygen tubing tangled through his blue hospital gown drew attention to the dried apple sauce over his chest. Despite his illness, he seemed happy for company. He straightened his blankets, smiled and motioned to the chair in the corner.
“Doc, you look tired. Sit down for a bit.”
I did, my smile hidden behind the paper of a mask and eyes shielded by plastic. We made small talk for a few minutes. I commented on his Detroit Lions cellphone case while we both mocked our favourite team’s ineptitude and the comical press conference of the newly hired head coach. For a fleeting moment, things felt normal.
“Well, I don’t think you’re here this late to laugh at a football team. The scan was bad, wasn’t it?”
I paused and looked around, hoping that some family member or friend of his may have snuck past security and found their way into his room. But he was alone. Obviously. And that loneliness permeated across the room to me. I explained the findings, the implications, the tragedy. He was stoic. At first, I was not quite sure if he understood. I stammered briefly and then tried to break it down a bit simpler.
He interrupted, “No, no. I get you. It’s just a lot. Is this as bad as it gets?”
We sat in quiet for a few moments.
“Can you do anything for this pressure?”
He was referring to his tense ascites. This was the buildup of fluid in his abdomen that signified the degree of his liver disease, the reason he first came to the hospital. I placed my hands on his abdomen and immediately felt his discomfort. I offered to arrange a procedure the following day to remove the fluid with a needle.
“Tomorrow?” he said coyly. “No, you wouldn’t let me suffer all night, would you?”
I stood there, thinking of the news he had just received and weighed the time it would take me to set up the procedure against the relief he would experience and, more importantly, the control he would regain. I smiled, behind paper and plastic and obliged.
The cold gel on the ultrasound probe marked the area for a safe puncture. The clenching of his jaw relaxing as the lidocaine slowly took effect. Finally, I slid the needle in. Amber fluid began flowing into a row of glass bottles. Litre upon litre draining.
During the hour, he told me some of his life’s story. The bar he snuck into when he was 17. The fight he started when he bumped into the wrong guy. The relationships found and lost. The joys, the regrets, the life. The person in the bed was so much more apparent than when I first walked into the room.
“See, now you can sleep knowing I can, too!”
He was right. I left that night much later than anticipated, but strangely, with a bit more energy than when it started. I spent the drive home thinking about him and the effect the night had on me.
I do not know if I would have appreciated this as much 10 years ago, let alone 12 months ago, but today, in our socially distant world, there was no greater catharsis.
The power of the doctor-patient relationship is not a new concept. What we do not talk about enough is the emotional healing physicians receive in providing this care to patients. In a world divided by politics, distance, paper and plastic, this beautiful symbiosis was just the medicine I needed.
“Doc, you look tired. Sit down for a bit.”
Lawrence Jacobs lives in Windsor, Ont., where he is also an associate dean of Western University’s Schulich School of Medicine & Dentistry.
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