“I just watched her… suffocating. In her own fluids. I kept asking if she wanted more help, if she wanted to go on the ventilator and all she was able to say was, ‘No’. I don’t know what to do, M. I don’t know how to help her. I can’t… I can’t watch her suffer anymore.” Pixelated tears turned into currents streaming down the face I’ve loved since I was 13.
Staring at J's outline on Facetime, all I could make out was the reflection of his phone's screen in his glasses. This was how we'd been communicating while he was in quarantine - in the same house but never physically crossing paths. To J's credit, as soon as I instructed him to self-isolate, he transformed our master bedroom into a little apartment, complete with a kitchenette and command center so he could continue to work remotely/play FIFA on Xbox without leaving the bed. Since I arrived home, I'd been placing meals outside the slider to our bedroom and waving at him through windows or from 12 feet away. Not a single complaint. Not one effort to "break" any rules. He had been a perfect, 100% compliant patient. But the cracks were starting to show.
Admit, discharge, admit, discharge - just moving the meat. In this assembly line, patients get in the way of the ruthless efficiency at which I'm expected to perform. No, not the body that supplies the blood for all the labs that get drawn every morning, ready for me to review so I can plan out the day's course of action - I need that. The actual patient - the one who paddled over white rapids and waterfalls, introduced thousands of students to their love of geology and was a loyal fixture in his friend's life through thick and thin - the one who's trapped in a failing body, I have no time for.
"Do you know what it's like to watch your dad try to reassure her for the thousandth time in an hour that he's there, just for her to call out for him again and again? After 70 years of marriage, he can't give her comfort because she doesn't even recognize him! This is killing him! And her! And to see her caged up in that bed is just sickening. No one prepared us for this when they diagnosed her with dementia. NO ONE." Robert patted his daughter's shoulder tentatively, almost as if to ration out his comfort in order for it to last them another day. His weary eyes locked with mine as he quietly begged, "Please do something."
As I see med students' anticipation rising for Match Day this Friday, I wonder if they wrote the same thing I did on my personal statement, if they said the same things in their interviews → I want to go into medicine because I want to help people.
8 years into this career, I wonder when help turned into a diagnosis/treatment algorithm:
Hypertension → lisinopril
Hyperlipidemia → statin
Heart failure exacerbation → lasix
Isn't spending the extra 10 minutes to help 30 people achieve closure after the death of a loved one also helping people?
Or is it not truly helping people if we can't toss them a pill or do a procedure to make it all better?
Did we really help someone if the encounter is non-billable?
Now looking back, I realize day one of residency started the erasure of tending to another person's humanity.