Years ago I worked as a registered nurse in a busy surgical pre-admission clinic, preparing patients who’d been scheduled for surgery for the upcoming operation and hospital experience.
My workdays were packed with back-to-back, hour-long appointments. Whatever surgery the patient was facing–oral, orthopedic or anything else–every interview followed the same format. I would greet the patient, who’d often bring along a family member, and quickly escort them both into my small office, seating them in the stiff, outdated plastic chairs facing my desk. On the way, trying to save time, I would explain that as part of the pre-admission process I’d need to do a health interview and a physical assessment, get an accurate list of the patient’s medications, labs, X-rays, EKG results, etc., and also tell the patient various details related to the pending surgery and hospital stay. In that same hour, I also had to chart all that I’d done and make a chart for the day of surgery.
I tried hard to keep the interviews running on time while also keeping the atmosphere warm and friendly. Overall, I felt successful at striking this balance, except when I encountered my biggest challenge: the (many) patients who veered off of the designated topic and onto others of their own choosing.
I’d ask a man if he had a support person to drive him home, for instance, and he’d launch into a long, rambling saga of family drama, isolation and loneliness, or describe all the ways he used to be active in his community. Another patient might wander off into a litany of physical complaints suffered at any time over the past twenty years.
Whenever this happened, I would struggle to listen for a moment, striving to produce the appropriately caring facial expression, then direct the patient back to the question at hand. After all, I had another patient due in less than an hour, and we still had much to do.
One day, an elderly woman slated for a joint replacement entered my office, in a wheelchair pushed by her tall, thin husband. Both in their eighties, they were wrinkled and shrunken. The woman, huddling crookedly in her chair, seemed much frailer than her spouse. Carefully pushing her chair up to the desk, he gently kissed her forehead before seating himself.
“Hello, I’m Paul, and this is my wife Mary,” he said, smiling warmly.
“How do you do?” I said, then turned to Mary.
“I’ll need to start by taking your health history,” I told her. “Do you have a history of any previous health problems?”
“She’s been playing bridge every day this week, so she must be pretty healthy!” Paul said jokingly. Mary smiled gently.
“That’s nice,” I said tactfully, then went on: “Mary, have you ever been told you have any problems with your heart or lungs?”
“Mary is breathing, and she has a warm heart, if that’s what you mean,” Paul quipped. “I will warn you that she can be a bit stubborn at times.” He glanced fondly at Mary, and she smiled back.
After several more of these pleasantries, I started to get irritated. Time after time, I took a deep breath and gently tried to redirect the interview–with no success. Paul’s remarks were entertaining, but we were getting nowhere.
There in black and white I saw the most beautiful young couple, swinging on a trapeze and clad in sparkling sequined outfits. Their faces were turned away from the camera, smiling boldly out at some unseen crowd. The photo seemed timeless; captured within its borders, they were forever young, vibrant and athletic.
Immediately, I knew these were the two people sitting before me.
“Mary and I have been married for sixty-two years,” said Paul. “We met when Mary was sixteen years old.” He looked over at his wife. “We were both trapeze artists, and when I first saw her perform, I knew I would spend my life with this beautiful woman. After we married, we became well known. We’ve traveled the world together, performed hundreds of times, and even entertained kings and queens.”
He sighed, then continued, “Now we are old, and our joints are worn out, our bodies are tired.”
He looked straight at me. “But we are still here.”
His words resonated inside me; I felt their truth. Gazing at this fragile, aging couple seated in my office, I saw in my mind’s eye the youthful, handsome pair swinging on the trapeze.
And I saw something more. After finishing the interview (not far behind schedule), I came away feeling differently.
In the gentlest way, Paul and Mary had reminded me to slow down–to focus on the human being I was taking care of. Recognizing each patient as an actual person with a lived history, I realized, is more urgent than gathering his or her health history or medication list.
Nowadays, as a chief nursing officer at a small hospital, I often tell the staff, “You’ll never hear a patient say, ‘Wow, you hung the correct antibiotic, and you did it on time!’ ”
Instead, I say, my patients will tell me how a nurse’s aide held their hand when they were frightened and alone…that a nurse was kind and patient…that a doctor looked them in the eye when telling them a difficult diagnosis.
Paul and Mary reminded me that, to be an effective healer, it’s not enough to strive for clinical excellence; I must also connect with the humanity of each person I encounter.
I will always be grateful to them for that lesson, and to Paul for his courageous and memorable words:
“We are still here.”
Audrey Cortez is Chief Nursing Officer, Otto Kaiser Memorial Hospital, Kenedy, TX. This piece was originally published in Pulse — voices from the heart of medicine, and is reprinted with permission.