What would you do when the one you love most has a terminal illness?
While going through my drafts today, I came across this piece I wrote as a third year medical student. I don’t share stories as often as I would like, but since starting residency, I’m grateful I recorded this down. I’m once again, reminded that all my patients have unique stories. They are more than their disease; they are daughters and wives, husbands and sons. And it is my responsibility, as a physician, to care for them to the best of my ability.
“They says it’s suicide.”
“You think? Well, I heard she was found down on the floor with empty pill bottles around her…”
“Oh her poor soul!”
My ears perked as I slowly made my way around the nursing station that, this morning, was filled with commotion and whispers about the patient I was about to see. I knew the basics: a woman in her mid fifties had been found unconscious in her home, brought into the ER by a concerned husband (not unusual)… and was now sitting behind the door of the room across from me. I was to screen for depression and the possibility of a suicide attempt.
I took a deep breath. If the first week of psychiatry had taught me anything – it was this: anything was possible.
And true to form, what I discovered was so different than what I was expecting.
“Why does everyone keep asking me about the car crash?? Like I said, the other car ran into me!” She howled, as she pulled her hands close to her eyes, covering her face.
“I’m sorry, ma’am but I have to ask…” I trailed off. We had heard from the husband that she had been in a car accident a week prior, and had told him that there was another driver who ran into her car on the highway. A few days later, he received a police report that detailed an entirely different story. She had ran her own car into a tree, and flipped it over.
I tried an alternate approach.
“Tell me about your family.”
I soon learned about her family: her grown children and their different personalities and careers, their own families, and her increasing grandchildren. Through her words, I could sense her dedication to her loved ones.
But we too quickly reached the present, to the current change in events.
Suffering from poorly controlled diabetes, she had a complicated leg amputation earlier this year. She lost her job soon after, and had been slowly losing her sight. Now, she was practically blind. On top of that, during this hospital admission, we discovered she had suffered a stroke as well.
And then, there was… her husband.
“My first marriage, oh – it was so young and stupid. We stayed together ten years before I was able to leave him. I was 17 when I got married, you know? Too young, too naive to know anything. But Jorge, this marriage… it was for all the right reasons. We married for love…” her voice cracked, “but it’s been too short! Only two years…”
“What do you mean?” I whispered, captured by her story.
“He… he was just diagnosed with terminal cancer. They found it too late. He has… about a month. I don’t know. Maybe shorter?” She broke down sobbing. “I don’t know what I’m going to do without him. I can’t be without him. I’d have nothing.”
“Would you hurt yourself if he were gone?” It almost felt cruel to ask. (But in psychiatry, you see, this is the number one question we had to ask to rule out suicide.)
“No.” she shook her head vehemently, “I have my family, and I have to be there for them.”
After her interview concluded, we diagnosed her with natural bereavement, which is to say – it is normal to grieve. Sadness is part of the human condition – if we try to treat it, and make it go away; what is there left of us?
Too often, in medicine, we over diagnose. We ask questions and we speak, but we forget to listen. Sure, we hear the words, but we don’t understand. Instead, we respond by placing our own judgement and interpretation onto the patient, forgetting to look and listen.
Today, I don’t know what became of that patient, or of her husband. But I am thankful for these special hours I was able to spend listening to her.