Thursday, June 21, 2012

Strength in life

The most profound experience happened the other day. I have been working on a stroke ward and in stroke urinary incontinence (inability to urinate) is a very poor prognostic factor (i.e. much greater percentage of people dying and much fewer regaining strength and independence).

Well, I have been holding back emotionally from the patients for reasons of being objective, professional, not knowing what to do or say, and just trying to mimic other highly effective physicians. But then the other day in the afternoon before going on my run, I went into a patient's room for a routine procedure. For some reason, I felt like I was entering my mom's hospital room and I treated the patient similarly to how I treated my mother. It wasn't that I said anything different, I just looked at her differently, like I loved her and I responded to her in a more personal fashion. Upon leaving, I saw her look at me differently, smiling with wide open eyes instead of sullenly and tired and miserable like every other time I have left her room. I know I opened myself up as that night I dreamed about visiting my mother in rehab, indicating that I had tapped into old emotions that I had kept walled off. 

With my mother, she knew she was going to live her worst nightmare. She had specific orders that if her mental capabilities were compromised, she did not want to live. She was DNR and my sister and I were fully aware of this well before the seventh grade. Then the way she died (and normal progression of her particular form of brain cancer) is that a tumor progressively ate out her brain from the top down, destroying her ability to think and focus, giving her seizures, and finally sending her into a coma for 2-4 weeks before taking her life. So what do you do when every day you see your mother in a wheelchair and know she is living her greatest nightmare and will be until the second she dies?

I saw the person I loved and I sucked up my pain and drew on her strength. When I entered her room it was about getting her to smile, laugh, draw out whatever fight or mischievousness possible so that she would try to walk or laugh or live another day. It is about seeing life and beauty and happiness wherever you can find it and that is what you develop and that is what you interact with and accept. I needed to be aware of the rest of her symptoms, but I needed to be her cheerleader and comrade.

I entered medicine with the belief that I can help people the way I helped my mom. Apparently after I left the patients room, she urinated on her own during a bowel movement, and did the next day as well. When she told me this I was so excited, which then got her excited. Normally when the attending MD and I round to all the patients rooms, she would be trying to sleep, complaining of the sun, and telling us she doesn't want her friends to visit because she wants to just rest. Instead she asked the nurse to find the attending to come and see her (she was so excited to tell the attending herself) and when we found her she was in the common room where it is even sunnier than her room.

So is this what it means to have a healing touch? Does it mean to open yourself up to loving a patient? Does feeling loved allow you to be strong? Might my being able to open up to a patient the way I did with my mom just have saved another person's life? I'll never know, but it is worth thinking about.

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