45 Minutes- an insightful round by Dr. Imbesat Maheen Syed (guest writer)

I am a Medical Officer leading a team of two students, a nurse, and an in-house doctor for what seems to be a typical ward round. We are seeing some patients that have just been moved under the care of our team in an Oncology unit.

While on round, one of my patients needs the nurse, who promptly leaves to attend to the call. As we move on, the students also leave for a class. The in-house doctor soon requests leave as well. I'm beginning to take all this as a sign of something insightful to come.

I am left to see the next patient by myself. I see her as any another patient who needs medical attention until we get into a conversation that is both remarkable and, as I foresaw my day to be, insightful. In a mere 45 minutes, my encounter with this patient will leave an extraordinary impact on the way I interact with other patients.

And so the 45 minutes begin...

I inquire about her well-being and get a vague response from her. As I'm taking notes in her file, she breaks the ice and asks about details regarding her medical condition. Even though this is my first interaction with her, as per her record, she has been admitted for a while but yet, to my surprise, she did not get the answers she was seeking. Her record clearly states a disease that does not have a very good prognosis. It is something no one would wish upon their worst enemy. She is suffering from Serous Cystadenocarcinoma. With high-grade Serous Cystadenocarcinoma, survival beyond five years is unusual.

She further tells me that no one told her anything about her diagnosis; and that in previous rounds, doctors would speak in medical jargon and were too busy discussing her condition with each other to talk to her.

She is inquisitive about the truth and anxious about my answer.

I break down the medical condition and prognosis to make it as simple as possible without omitting any major details. I let her know very clearly the statistics relevant to her disease. My response is purely evidence-based and I leave no room for subjectivity in what is her personal journey with herself and God. I let her be the judge of her own prognosis. Interestingly (and paradoxically) enough, all her anxiety and apprehension that she was harbouring a moment ago, resolves almost instantaneously. The storm in her has calmed.

In this red-hot minute, she decides that she is ready for recovery and healing. She is so strong in this moment. She tells me that during her hospital stay she didn't let her children visit her, but is now going to call them and let them visit. She wants them to be part of her journey to recovery and gain strength from it. She wants to teach them the essential lesson of going with the flow of life.

During this insightful conversation, we talked about the beauty of life and how there is so much to appreciate in every moment. She tells me that she is into crafts, so instead of lying in bed all day, she would like to knit and crochet and give proceedings for charity. In a heartbeat, a person we thought was in need of help is so overflowing with life that she has now become a 'giver'.

We must give our patients a chance to live. Sometimes, poor choice of words can extinguish their hope and doom them to death, even when it may be inevitable. The fine balance is in not giving them false hope, all the while avoiding, limiting them to a particular statistic. Lay out the details for them and some might just decide to 'live'.

During the next few weeks, she recovers with unremarkable investigation results.

I am now rotating in a different unit. To this day, I still hope she is living her life to the fulllest somewhere.

[from Narrative Medicine]

CREDITS:

About the Author: Dr. S. Imbesat is a clinician, researcher, reviewer, author, poet, writer and artist. She aspires to explore different elements and aspects of life and share them with her audience.

Edited by:  Rohail Shahid is in his second year of university, studying Medical Sciences with a focus on Genetics. His goals for the future are to enroll in a Medical School and/or commit to research in the field of Genetic Engineering. When not on campus, he can be found at work tutoring high school students or watching/rehearsing contemporary musical theatre.

Editorial Note: This is from a 'phase II' continuation of Narrative Medicine at AKU - what started as a Workshop-based initiative on January 20^th, 2016. The editorial work was performed by the Writers’ Guild, an interest group at AKU, with the purpose to promote love of reflective reading and writing, within and outside of  AKU. 

     

DISCLAIMER: Copyright belongs to the author. This blog cannot be held responsible for events bearing overt resemblance to any actual occurrences.