Abstract
“T
The candor and bluntness of the statement makes me cringe as I turn my focus toward the nurse who just spoke. I proceed to ask a question that I already know the answer to.
“Do you mean Ms. Camp?”
Looking down at a handful of papers, she hastily thumbs through them only to arrive at a one word answer of “Yes.”
I find it painful and demoralizing to hear people referred to as room numbers or patients. It seems so dehumanizing in a medical world burdened with quality metrics, economic disincentives, and productivity measures. I reflect back to medical school, where as a third-year student, a young man was presenting in morning report. He started off with, “A 39-year-old female—”only to be interrupted by one of the attending physicians. “Excuse me? Could you repeat that?” He cleared his throat and in a much louder and confident voice stated “A 39- year-old female—” Old Dr. Weibel piped up again. “Excuse me but people are not male or female; animals are classified as male and female. People are women and gentlemen. Give it one more shot. Maybe this time you can get it right.” I'm not sure if the chiding was necessary, but the point was dead on and one of the most important that has ever been made at any morning report, grand rounds, or national conference I have ever attended.
The nursing station continues to churn but the thought of mortality resonates within me.
I did not know Ms. Camp when she was in good health. In fact, we only said a few words to one another. My time was spent primarily with two of her six children, Lauren and Chris. Lauren was in denial and handled her mother's imminent death by not talking about it. Chris, unlike his sister, needed as much information as possible—his mother's current medical condition and what to expect as she entered the last few days of life. Nothing I could say would prepare him for what would follow once his mother died.
I am brought back from my thoughts by the loud wailing of a young man, undoubtedly emanating from Chris. It's a sound I have heard before, one that I myself have screamed as I felt my heart break again at the thought of an endless loss.
The nurse is asking for someone to come and pronounce Ms. Camp. She is unrelenting with her request. How, in the face of death, with a loss of this magnitude, can this be our focus as caregivers? Why must we shift our focus away from the humanity of the situation? The family needs a few minutes to grieve before medical personnel begin asking innumerable questions. The third-year medicine resident tells me he will take care of it, that I should go home (he knew that I was preparing to leave just before Ms. Camp died).
“I want to stay. In fact, I need to stay. I will go in the room with you,” I tell him.
“Why?” he asks with an inquisitive tone. “What will you say?”
“Not much. I will offer my condolences and just be present. They may have questions. They may say very little. The only thing I know for sure is if we don't go in there, they will feel abandoned by the very people who promised to take care of them, and that will be a lasting feeling that will never go away.”
We enter the room. The family is sobbing as Lauren gently strokes her mother's face. We stand silently, reverently just inside the door. Chris comes over, gives me a hug, and says, “Thank you.” My eyes fill with tears and I wonder if this will ever get any easier. I hope not.