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Medical Humanities

The Boss

Katherine O'Brien
November 24, 2018

The emergency room attending hands me a patient label. I look down at the name on the sticker, and my breathing immediately quickens. No one ever prepares you in medical school to have to care for the man who has inspired you most as a physician. The alarms and steady hum of voices fade from my consciousness as I head to the room, take a deep breath, and pull open the curtain. My heart is racing, and I know I am smiling too much. He is lying on the bed, his eyes closed tightly, and he looks so tired. He is wearing his signature baseball cap, but his white coat has been replaced by a stained hospital gown. We make small talk, and I'm sure he can sense my awkwardness. Finally, he says, "Should I just start from the beginning?" It all started with a headache. He cringes a bit as he talks about opening his MRI and seeing the tumor that was there. “A piece of advice, never interpret your own tests.” He chuckles a bit after he says that trying to break the tension, but neither of us find it very funny.

 

He sighs after he lists off his medications, because prior to this he had never taken a single pill in his life. The physical exam is even more awkward, as I am terrified I will make him uncomfortable. I find myself concentrating intently on trying not to expose him too much but making sure to listen to his heart and lungs on his skin and not on top of his gown. He was always so adamant that we do so when teaching us as medical students. I silently try to will my hands to stop shaking so he doesn’t see how nervous I am. Then I have to ask the code status question; one that I have asked a thousand other patients.

 

He starts to cry when I ask that and tells me about how he is scared to leave his family. He talks about how much he loves being a doctor and a teacher and how it isn't fair that he has to give those things up so soon. He reaches for my hand, looks me in the eye for a few moments, then smiles and says, "It has been a pleasure watching you become a doctor."

I met him on my very first day of medical school, when I was still certain that someone was going to realize that a mistake had been made and that I actually didn’t belong there. He remembered I was from Indiana, and when he asked me how the Hoosiers were going to fare in the NCAA tournament that year, I immediately felt at ease. As a second-year student, he used to take us on rounds for physical diagnosis. I was always in awe of how easily he was able to connect with patients. As a fourth year medical student, he laughed while I was sitting in the big blue chair in his office, worrying about matching for Internal Medicine residency. As a resident, he encouraged my burgeoning love of caring for the elderly.

I had known he was sick. All 90 of my fellow residents gathered in a hot, cramped room one day while he told us the news. We sent flowers, and we bought pins to wear on our white coats. I had seen him in the hallways, gaining weight from the steroids and losing his hair. Some days the residents whispered to each other about how we couldn’t believe that he came to work at all; but we all knew it was because for him, medicine was never really just a job. I knew all of this, but until that moment, it was all just whispers I had heard in passing. Then suddenly it all became real. In that moment, of completely unexpected role reversal, in the middle of a crowded emergency room, he had become my patient. I had spent years learning from this man, and now he was looking up at me, as his doctor, and I could do nothing. He was supposed to go on to be the chair of the department or the dean of the medical school, accolades I would hear about in passing through the alumni group. Instead, he was here, wearing the same stained, green gown as all the other patients in the emergency room, powerless, and enduring yet another admission to the hospital.

I can feel the tears welling in my eyes, but I don’t want him to see me cry, so I choke them down. I have no idea what to say. My mind is completely blank. I frantically search my memory for the right words; all of those tidbits they teach in patient-doctor communication classes to make people feel better, but none come. Maybe the right words don’t exist for a moment like this. All I manage is to get out is a quiet “Oh.” Then there is silence. The screams of a drunk patient next to us breaks it.

I fumble my way through the rest of the admission, and then seek solitude in the bathroom to cry. Even though my pager is going off constantly, I force myself to take a few minutes to collect myself, because I know he would want me to. I wipe the mascara off my face, I put my white coat back on, and step back into the emergency room. I still have seven notes left to write.

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