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Editor's Comments on 'Your loyal mashed potato plumber sidekick'

 , October 13, 2016

I was in the midst of a Palliative Care and Hospice elective when I first read Herbert Rosenbaum's "Your loyal mashed potato plumber sidekick," and I couldn't have come across his poem at a more appropriate time. This quirky, heartfelt testament to a patient struggling with dementia hits all the necessary emotional points: nostalgia for the husband now lost in the fog of cognitive decline, heartbreak at the friendly spirit that survives, and the whimsical delight embraced by the narrator. The entire poem is wrapped in an attitude of play, of engaging with a patient on his own terms and approaching the encounter without predetermined goals. Rosembaum's piece represents a model of a patient encounter that is contrary to everything we have been led to believe about a doctor's visit. Instead of viewing the dementia as an inconvenience to his medical exam, the narrator is happy to "find the sewing kit" and accompany the patient on any adventure that strikes his fancy.  He takes the dark cloud of paternalistic, physician-centered medicine and dissolves it in a cup of steaming tea. The result is an ode to this patient, a recognition of his unique peculiarities through which Rosenbaum honors the humanity still present but often overlooked in all elderly patients with dementia. 

Although I was lucky enough to read this piece while steeped in the care of patients at the end of life, these themes are necessary to emphasize at all points in our training. Physicians are often taught to think of themselves as heroes staving off death and saving the day, placing enormous value on the creation of a legacy of research and accomplishments. With poignant grace, Rosenbaum removes this ego from medicine. The physician is referred to in lower case throughout, a humbling move that culminates in the final paragraph. Forget a 15-page CV and an impressive research grant, the narrator would be fulfilled if he were remembered simply as a "loyal sidekick" to his patient. And with the word "maybe," the reader discovers that even this legacy is not necessary. The focus instead is on the lasting memory of the patient himself and the final gentle promise marking the sacred relationship between doctor and patient: "even when Your light dims/i vow to care for You, always." 

Mara Feingold-Link