Imagine being admitted to the hospital for hypoglycemia to leave it with a startling revelation: cancer. Now, imagine breaking that news, imagine the aftermath, and imagine the possible expectations...
In medical school, cancer was just a topic, a crucial issue that screams fatal, growth, and loss. I remember how I was always uncomfortable around it. It was like an unfavorable itch. It's also unfortunate that we were never actually taught how to deal with cancer patients. (Or maybe that just applies to me). How do we properly break down the news? Because we don't need one of those other PowerPoint presentations that tell us what to do in bullet points instructions.
During my last week in my medicine, I covered a patient in his mid 50's who got shifted to the medical wards. He was known as the zestful, talkative patient in our unit. And by talkative, I mean you'll end up locked in for an hour or two unless you're someone who smartly knows his way with words to run loose. I remember pulling up a chair from the hallway to sit next to his bedside. He loved to talk, like all the way to his childhood, then to the current present, and the possible future. Sometimes the conversation becomes a broken record, and I end up hearing the story all over again.
I tend to have a hassling nudge when I feel tangled. As I sit opposite to the patient, listening to what he had to say, my body twitches silently as my thoughts urge me to excuse myself since I had a list of tasks that I had to finish by the end of the day. But I couldn't. The idea of rushing out plants a seed of hesitation in my head:
What if this makes me look rude?
Do I want to be defined as a careless doctor?
So I stay for an extra 30 minutes. I was listening to his story again, probably for the third time, until he says something that stirred my core. Then I became grateful for the extra 30 minutes. He noted that nearly 87% of clinically ill patients are handled psychologically. No matter how terminal they are, a psychological intervention was a necessity. I don't entirely mean that every patient needs to be seen by a psychiatrist. Still, a trivial form of psychotherapy might aid a patient's concerns, like difficulties in coping with daily life, the impact of trauma, or a medical illness. I imagine what the patient essentially meant is that he wanted to feel like he's been cared for. Something I believe every patient craves. This makes me realize that what all patients need is as basic as flour in a recipe for bread: show them that you care.
For years we've been taught how to build a genuine relationship with our patients. How to allow them to trust us with their health. When the relationship is strong, your patient's health will improve, and it doesn't imply physical health, but mental too. The reason why I'm shifting to this "how to be caring enough" topic began when I witnessed how my senior doctor broke down the bad news to my patient. It was never like SPIKES; it was like a hiccup: quick, sudden, and came by surprise. And that was it. We stayed for 10 minutes, probably less, then moved to the next patient.
So to make him feel less terrible about his recent esophageal cancer diagnosis, I try to sit with him for a few minutes after rounds and answer what I could possibly give an answer to. I even made him a list of all the food he could eat (as he requested since he was afraid it would affect his cancer). I tried to do the bare minimum, show him that I care, that I'll try my best to be available most of the time, which is impossible. And to my surprise, my brief time with him made him reminisce a good memory that made him laugh—a laugh in a mid of a crisis. I was astonished. A small act of kindness (caring) can indeed make a difference.
Now I understand that doctor duty does not come easy and almost always busy but aren't we here for them. Aren't we here to help them, to fully commit to them. Because that's what we signed up for. Transparency, active listening, trust, care and communication, respect represent a list of what patients deserve from their doctors. It's part of the planned regimen, but we don't primarily see it.
You see, getting a warm welcome when checking into a hotel shows friendliness, but in a doctor's office, it's a game-changer. Caring is key. You could change up a patient's life even if you couldn't treat them. As Mandy Hale once said, 'To make a difference in someone's life, you don't have to be brilliant, rich, beautiful, or perfect. You just have to care.'