Today, I had a class on incorporating the humanities in medical education. We were asked to write a short piece of prose or poetry on a patient encounter that haunts us. Hearing what others wrote was way to much for my hormonal psyche. I didn’t share mine because I was too busy trying not to let anyone see me cry about the ones that were shared.
I am not a poet, but it kind of has a poetic feel, I think… Here it is…
You did your best. You knew something was wrong. You were low risk, they said. But, now, you are sit in clinic and don’t know how bad it really is.
You are angry and scared. You cry when I review what is happening within your body. I am gentle, but I am up front. Medicine is so advanced, but so limited.
Together, we bring you down off that ledge. We have a plan. You know what is likely to happen. Then, I point out you need to meet my staff. To keep in mind that a chance for second opinion isn’t gone.
Gruff and curt, he approaches. The plan changes and you are confused. There is no explanation. Just a closed door.
I try to help you understand. I feel a sense of loss. Like I am free falling in a place outside of my control. It can’t compare to what you feel.
You don’t want another opinion. You trust him. Because you trust me.
In that moment, I don’t trust me.
I go home and review the literature. I think and think. I talk to another staff person. I am right. There may be more. But, how does that get approached? Who is willing to speak up?
Everybody talks, but nobody deals. That seems to be the way sometimes. The questions are brought up, but I wonder if they were truly dealt with. They get swept under rugs that some of us can’t help but look under.
This time, someone did say something. This time, something did change. Somehow, the suggestions were accepted.
I was relieved. I want the best for you. I want the best for all of you. But still, the whole thing is unsettling.
In the long run, will it be enough? Will you continue to get the care you deserve?
If I hadn’t been there, if you didn’t trust me, would it be different? Would you have made a different choice?
Maybe it is enough. But, I wonder if we could do better. I wonder if it is my fault. That my being nice, that we “clicked” made you not question, not request that second opinion.
I won’t know. I can’t help but wonder it is my fault. And I’m not even sure what “it” is.