Friday, September 30, 2011

The Ties That Bind

I saw a familiar face amongst the crowd of children dusting the snow off their boots and replacing them with soccer shoes. My wife and I stood in the corner and watched our daughter run into the middle of the gym and socialize with a group of little girls.

As the woman approached I realized she was a former patient. After a brief exchange of greetings her eyes opened wide and she developed a lump in her throat. She turned to my wife.

Your husband saved my life!

She then excused herself to fetch her parents who were helping her daughter get changed for practice. She wanted them to meet me.


I will never forget the early morning during residency when I struggled into the hospital with the stomach flu. Between each patient I had to run to the bathroom to vomit. It was one of the hardest days of my career.

Or the time when one of my fellow residents showed up for a weekend on call yellow. Literally yellow from jaundice. It took several hours to convince him to go to the emergency room. Fortunately it was just a bad case of Mononucleosis.

So when Sheri arrived for her ICU shift with a severe headache, she sucked it up like everybody else. As the night progressed, however, she knew something was wrong. Her vision became blurry. Her speech started to slur.

The nurses put her in a wheel chair and sped her through the maze of passages to the emergency room. Upon arriving she had her first of several seizures. Two weeks later she would leave the hospital for a rehab facility with a diagnosis of terminal brain cancer and a fresh scar on her head to prove it.

Sheri struggled over the next few months. She measured life's ups and downs with little triumphs. By the time she walked down the isle with her long time boyfriend, she used only a cane.

A year later she was rounding with the rheumatology consult service. She was no longer a resident but she didn't want to abandon her life's work. She missed every other day for chemotherapy, or radiation, or doctors appointments.

Her life had been extended but her clock was still ticking.

Each resident regarded Sheri in a different manner. Some ignored her. Others acted like nothing had happened. And some of us struggled to treat her as if she was anyone else going through something horrible. We walked the tightrope between caring and melodrama.

After leaving residency I would never hear of Sheri again. A decade later I assume she is dead.


As the soccer game began my wife stood by my side smirking. She knew how uncomfortable I was with public recognition.

After all, I didn't really do that much for the woman. She came to me with a mild case of post partum depression. We talked about medications and therapy. But mostly we just talked. I was also a new parent. Like her, I was exhausted and overwhelmed. I was tired all the time.

For brief moments, during our visits, we felt like fellow soldiers in a an arduous battle. Apparently, for her, the personal connection did more then medications or therapy could.

And I thought of my residency program. I thought of my years as an attending. As physicians we spurn our own personal illness as if it does not exist. We stand above it as if we are superhuman. Our patients may get sick but not us. We try to lift ourselves out of the fray.

But what if our own mortality serves a purpose?

What if our frailty is neither embarrassing nor an Achilles heal?

Maybe. Just maybe.

It is the tie that binds.

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