Could a greater miracle take place than for us to look through each other’s eyes for an instant?
-Henry David Thoreau
It is almost 7:00am I carry my briefcase and lunch bag from the car to my office. I nod to some of the night shift employees heading home. Another day has begun.
I type my password and check the computer, reminding myself of the twenty patients I am scheduled to see today in the cancer clinic. A few new consults with untreated or recurrent cancers occupy the longer appointment slots. Follow-up and post-operative patients will be seen more quickly. It will be a full day but, hopefully, I will grab a few minutes around noon to eat my sandwich.
I print out some office notes and carry them with me to our weekly 7:15am tumor conference. Several physicians present cases for discussion. We review the scans and the pathology, making recommendations for treatment. We determine who is eligible for a clinical trial. We look at recent research results. Usually, a brief discussion will mean better news for the patient; we have something to offer. A longer discussion can reflect the lack of good options.
Clinic gets going. First is a 64-year old man with a tongue cancer. Symptoms have been present for about six months. The scans are helpful. The cancer has not caused much damage. Only one lymph node is involved. Everything else looks fine. I run through the surgical risks, benefits, and alternatives. I prepare the consent form and look at the schedule. Any questions?
He drops his head, hands gripping his knees. “My wife would have known what to ask,” he tells me. “She died six weeks ago. That’s why I waited to come in. I was caring for her.”
I pause. There is a story pressing in on us from all sides. It floods the room.
“I am so sorry,” I reply. “I am glad you are here. Your cancer is still very curable. Tell me about her.”
We spend some time. I am soon behind on my schedule. There will be more stories that need to be shared before the day is through.
A recent YouTube video from the Cleveland Clinic is a spot-on rendering of what happens every day in a hospital. See what you think.
No matter where we are, stories surround us, but they are closest to the surface when we are most vulnerable. Recognizing this reality should be part of the repertoire of every physician. We teach this to our students and residents. Even still, how easily we all forget.
The day in clinic draws to an end and everyone has gone home. At 6:00pm, my charts are half-complete. I pick up my briefcase and lunch bag. I find my car and head home.
Tomorrow will be here soon enough.
Bruce Campbell is an otolaryngologist who blogs at Reflections in a Head Mirror.