In the midst of seeing a patient, I got a call from another physician, my dad’s new cardiologist.
“Looks like he is going to need CABG (open heart surgery) since he has four major blockages.”
I was expecting this call, and this result, based on his history of diabetes and at least one month of chest pain. It was still shocking to hear. I walked back into the exam to continue the visit with my own patient with diabetes, probably visibly shaken, so I shared the news with him. Would this medical disease so close to home change the care I provide for my patients? Yet to be determined, but now it was time to cancel the rest of this week’s patients and hop on a flight to help take care of my dad (and family).
As physicians we become accustomed to taking care of disease day and night; we follow guidelines. But, do we get entrenched in the care of so many others that we become numb to bad things that happen? Does the art of medicine get lost in the shuffle? I have taken care of many patients after CABG, most have done very well, but will my dad be the same? Was I aware of their emotional needs after surgery or just the logistics of moving forward with their medical care?
My dad lay on the stretcher in the pre-op area surrounded by his family (and a stuffed Kermit the Frog, his favorite character). Surprisingly, he appeared calm, but knowing him, I knew he was terrified. The anesthesiologist rattled through his meds, which I knew all too well, and my dad looked at me for approval. I nodded, and before I knew it he was being wheeled into the OR.
I spent many of the following hours on my practice’s electronic medical record responding to patients and reviewing patient data. I felt generalized anxiety. Why was I attempting to care for my patients at this time? Was it something I could control?
Many hours later I spotted the surgeon coming our way, like right out of the movies. His face was blank. No thumbs up or smile. But then it came, “It went well, he is doing fine.” Relief had arrived, just as it had for many of my patients as I shared good news, and it was sweet.
The surgeon escorted my mom and I back to review the films of my dad’s coronary arteries. As I glanced at the images, like I had many times before, it clicked that I was looking at my dad’s heart. That was surreal. It was clear that without this intervention it might have been a very tragic outcome.
The following days in the cardiac unit went smoothly. The care was like the well-oiled postoperative machine that I know well and am proud to participate in back at my hospital. There were discussions amongst his physicians about his diabetes meds, and despite them looking for my insight, I opted out; this is their patient. I started craving my own practice, my own patients.
In the weeks that followed, one of my patients prepared for CABG. I felt better prepared to discuss the process with him, including the emotional impact it might make. I saw him right after surgery, as I had seen my dad, and as he smiled his appreciation that I was there rang through. This is medicine, I thought. This is doctoring.
I made a point to see him through his inpatient rehabilitation and discussed that he will feel weak and possibly depressed for some time, and this is normal. These interactions were not about his diabetes control or checking off boxes in an electronic medical record to please the insurance companies or administrators; they were about a patient and his doctor.
I worry that as medical technology catches up with other businesses, more clinical guidelines are developed, and there are more industries with a vested interest we will become more like robotic clinicians rather than the caring doctor at the bedside. My dad’s surgery helped bring me back to the priceless art of medicine that has become easy to lose for many of us in the piles of tedious paperwork, the useless bureaucracy, and the barriers that keep us from our patients. I’ll take this as another valuable lesson from father to son.
By the way, my dad is doing great.