As a doctor and a son, learning to let go

Emotional challenge: Physician learns to trust in care for his own mother

May 5, 2009 

It’s a special challenge for a physician when a loved one is seriously ill.

Education can never quite prepare a doctor for the experience. And, paradoxically, there is much to be learned from such a time.

All of us in the field of medicine are taught that when it comes to family or close friends, it is wise to recuse oneself from the role of healer. Competing emotions cloud judgment and can interfere with the best of intentions.

I’m facing such a challenge now as my mother contends with a serious cancer. She’s been fighting it for several years, but now it has metastasized to her brain and she’s had several close brushes with death while she has spent the past month in the hospital where I work.

My mother’s stay began as do many patients’: in the back of a medic van. She was in severe pain and I felt incredibly grateful that we have paramedics that can offer strong relief for pain just as they treat other, more graphic emergencies.

Then she was in the emergency department, the place I’ve written about for the past 10 years. It was weird, despite my training, hearing my partner use the same general words I do, trying to balance the right blend of hope and reality.

How serious was this going to be?

It turned out to be very serious – her bowel had ruptured and was leaking into her abdomen. She would need emergency surgery. I knew much better than my siblings in the room just how close to death she might be.

She survived the surgery. After a couple of nights in intensive care, she was ready to go the general surgical floor to convalesce. Now she had to deal with her cancer, her seizures – all the other medical issues she was dealing with before the surgery.

This is where it got hard. Out of a desire to see that she got the best care, it was tempting at times to look in her chart, to monitor the laboratory tests and X-rays, to be one of her doctors. I felt this in spite of knowing its foolishness.

There are actually laws against this behavior. The federal laws regarding patient privacy forbid me from doing so.

Like any other family member, I needed to communicate with the nurses and doctors caring for her. I needed to trust them – just like I ask my patients to trust me.

One unexpected lesson during this time has been observing the small aggravations that sometimes occur in the course of hospital care. This experience of what it’s like “on the other side” reinforces simple lessons that will make me a better doctor.

Good example: a nurse not introducing herself. She was obviously busy, but I’d never met her before and it would have taken her 10 seconds. I was struck by how awkward it felt to have this person talking to my mother and seemingly ignoring me.

Another example: a tech not washing his hands before caring for my mother.

A small error, but it has become increasingly clear that a lot of these small errors add up to increased infection risk when multiplied throughout the hospital.

But these were small incidents among weeks of excellent care. My overwhelming emotions are gratitude and admiration for all of those involved in my mother’s care.

In today’s hurried world, it is unfortunately common that few people show formal appreciation for the care given to themselves or their loved ones. I have a stack of thank-you notes to write.

My mother is in the rehabilitation unit now, trying to learn how to cope with her partially paralyzed body.

There still are many challenges ahead for my mother and the rest of my family, many lessons to be learned.

What’s the best way to be a son who’s also a doctor?

She doesn’t need my medical advice. Instead, I do my best to visit her every day, hold her hand, ask what she would like for a special snack, and kiss her good-bye after each and every visit.

Today’s column is by Dr. Joe Pellicer, who works in the Emergency Center at Providence St. Peter Hospital. The thoughts and opinions expressed within this article are his own and do not necessarily reflect Providence Health & Services. Dr. Tom Burke is the director of the Center for Global Health at Massachusetts General Hospital and a Harvard University faculty member in emergency medicine. Go to www.notesfromtheer.com.

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