I am a physician.
We are always taught to see our patients as more than their state of illness or diagnosis. “Speak to the patient,” “listen,” “look them in the eye,” “do not put one foot out the door,” the list of do’s and don’ts, while self-explanatory, is long. A good doctor is considered one who is able to view the person behind the symptoms and offer a shoulder, not just for their physical problems but their emotional dilemmas as well.
Which is all very good.
But I felt compelled to write today because the recipient today was me from a patient.
Jean and I (identifying information changed) have known each other for some time now. She has had type 1 diabetes with every possible complication for years. Eye problems, amputations, severe high and low sugars, neuropathic problems, heart problems, dialysis dependence: You name them; she has them. Still young, but so burdened. I do not know how well she cared for herself during the initial decades of diabetes, but I do know that for as long as I have known her, she has always come across as one who makes the best efforts in managing this disease that has so consumed her life. She never complains and never blames anyone for her predicaments.
It is this woman that I was going to talk to today as a video visit on a routine work day. And it was during this video chat that she disclosed to me that she had decided to stop dialysis, and allow nature to take its course, whether that took days or weeks or more or less. She was done fighting.
Both of us knew what this meant. We knew that this could very well be the final goodbye.
We chatted about hospice. She agreed to get a blood draw for an absurd insurance red tape just so she could continue her diabetes devices in her last days without going through more discomfort and pain. I complained about the completely unscientific lab requirement – we shared a moment of helpless resignation to the rule book. I wished her all the best and peace. She seemed to stare at me through the computer screen for a moment. She then said she wanted me to know that I was a good doctor and that I should let no one tell me otherwise. I thanked her. We hung up.
In my years of being a physician, I have had several patients pass away. Some got the chance to say goodbye; some didn’t. I am not quite sure what it was about this goodbye that touched me so much. Perhaps it was her thanks to me as her physician. Perhaps her recognition of me as a person with her “last words” has stayed with me.
She didn’t have to say anything so emphatically. But she did. Without some score card or patient evaluation. Something inside her knew that her words would carry me in my times of frustration and cynicism. She had the courtesy to make the extra effort to reach out to my emotions beyond my physician persona over and above her own struggles. She chose to recognize me as a human being with feelings, hurts, and fallibilities, a weight I carry every day without thinking, a weight much greater than some ethereal god or a lifeless automaton.
In acknowledging me, she gave me my own gift of humanity back – so precious that I will cherish it for as long as I live.
Tarang Sharma is an endocrinologist.
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