“He is not about to cry, is he? Whoa, he is about to cry! Where is the Kleenex box?!?” I sat there in my VA clinic just last week with these questions roaming through my head. I was anxiously staring at my patient just having told him this would be our last meeting together. This was a 70 year old, stoic veteran who proudly served in Vietnam if my memory serves me correct. Did I just unknowingly insult the gentleman or was he having excruciating pain? Maybe he was passing a kidney stone or something.
It literally took me half a minute before I realized this man of few words I had been honored to help care for was really emotional because it hit him that this really was our last visit together. It’s always difficult moving on and now that I am completing my final year of fellowship I expected departing from my patients would be emotional as always. However, I hadn’t really taken time to see the impact physicians can have on the lives of their patients and how deeply they also influence us. My patient wiped his face and said in a quivering voice, “You know… I thought I was going to die that day until you came by and spoke to me?”
I had met this gentleman nearly 3 years ago in his quiet room at the Durham VA hospital and thought it was another routine consultation for hyperthyroidism. He was actually admitted with atrial fibrillation with rapid ventricular rate and subsequently found to have significantly elevated thyroid hormones. His wife and daughter stood anxiously at bedside waiting for me to give them any news. I could tell that just like many patients I had been consulted on, this family was utterly confused as to what was going on. Doctors and nurses had been in and out, in and out for the past 24 hours. I sat on the bed next to the patient and smiled. If I tell you I remember what I said to this lovely family I would be lying to you. I don’t recall anything special at all I said or did. Sitting there I do remember reaching for a paper and drawing out the brain, pituitary and thyroid gland. I then diagrammed this endocrine axis until I began to appreciate heads nodding around the room. This was a fun habit I had picked up during medical school back when I had plenty of time on my hand. I would return to my patient’s rooms at the end of the day and answer questions or explain their disease. I found this was a great way not only to educate the patient but also myself.
It is sad saying goodbye to my patients over the past few weeks. Each clinic I have that old Boyz II Men song playing in my head. I wish I can pack them all up in buses and bring them along to my new practice. I am extremely honored and privileged to have served them for the past three years at an amazing institution. As physicians, we often don’t grasp how important our 10-15 minutes consultation visits are. Simply smiling at a patient and taking time to answer questions garners trust and really goes a long way in fortifying that doctor-patient relationship. In this day of electronic records, technology and meeting specific hospital quality goals, many obstacles hinder these relationships. We must always be cognizant of this and realize our attitudes, facial expressions, and words can really affect our patients. We should treat each one as though they are a loved one. Even on a larger scale, the way we treat our neighbors will also influence our destiny (Matthew 25:31-46, Mark 12:28-31). This resonates well with Hebrews 13:1-3 and with a 33-year-old carpenter’s son who washed the feet of men.
Needless to say, my end-of-fellowship clinics have been extremely humbling and gratifying. It reminds me why I chose to become a doctor. Nonetheless, at times I feel as though I have been in a 10 year slumber since college and sacrificed a lot of life’s youthful pleasures in pursuit of my dreams. The ten year training period post-undergrad has finally come to an end and I finally realize that the light at the end of the tunnel wasn’t a train after all! .