Goodbye, Mrs. W
Did I say that I enjoyed gyn/onc? I spoke too soon.
Mrs. W is a fiesty, strong-willed 68 year old woman who reminded me of my own mother. She had an ovarian mass that we surgically removed. Unfortunately, we didn't help her at all. It turns out that Mrs. W has a metastatic GI cancer that is going to kill her in a few weeks.
I had grown to like Mrs. W during her hospital stay. I will never forget the day she got her prognosis. The gynecologic oncologist, the medical oncologist, the chief resident and I all crowded into a small room with Mrs. W and her daughter. With a flinty stare, Mrs. W asked the doctors to be complely straight with her about what was going on. They were. She seemed to take the news rather well, considering. Her daughter, however, fell to pieces. As my eyes welled up with tears, I fought hard not to follow suit. I was suddenly transported back to my father's losing battle with prostate cancer. At that moment, my professional veneer slipped and I was no longer a doctor. I was a daughter facing the loss of a parent. I hid behind the medical oncologist and stared my tears away.
After rounds I slipped away to my call room and cried like a baby.
The very next day, as if by magic, all five of Mrs. W's daughters appeared in her hospital room. They had come at a moment's notice from all over the country, leaving jobs, husbands and children behind. That morning, the mood in the room was surprisingly light. The daughers were cracking jokes and I could see they had inherited Mrs. W's sense of humor. I did see one daughter's face crumble once when she thought no one was looking, but she made a quick recovery. When I left the room, I noticed that one of the daughters had posted a hand-written note on the door:
"Outside this door we may fall apart. But inside these walls we will be a source of love, encouragement and support."
After that, Mrs. W was never alone for a single moment. Her daughters kept a bedside vigil, even spending the night in her room. They worked shifts. I would see a different daughter every morning and several of them in the afternoon. After my daily physical examination, a daughter would follow me outside of the room and ask questions. Sometimes the daughter would cry and I would struggle not to do the same.
Today, we discharged Mrs. W from the hospital. She wanted to die in her own home.
As strange as it may sound, there was beauty in this experience. As an Ob/Gyn resident I spend most of my time witnessing birth, not death. For me, the joy of delivery is being in the presence of family love as they welcome a new member. The way that Mrs. W's daughters surrounded her with love was as moving as watching new life enter the world. May we all be fortunate enough to die in the same way.
Goodbye, Mrs. W.
Mrs. W is a fiesty, strong-willed 68 year old woman who reminded me of my own mother. She had an ovarian mass that we surgically removed. Unfortunately, we didn't help her at all. It turns out that Mrs. W has a metastatic GI cancer that is going to kill her in a few weeks.
I had grown to like Mrs. W during her hospital stay. I will never forget the day she got her prognosis. The gynecologic oncologist, the medical oncologist, the chief resident and I all crowded into a small room with Mrs. W and her daughter. With a flinty stare, Mrs. W asked the doctors to be complely straight with her about what was going on. They were. She seemed to take the news rather well, considering. Her daughter, however, fell to pieces. As my eyes welled up with tears, I fought hard not to follow suit. I was suddenly transported back to my father's losing battle with prostate cancer. At that moment, my professional veneer slipped and I was no longer a doctor. I was a daughter facing the loss of a parent. I hid behind the medical oncologist and stared my tears away.
After rounds I slipped away to my call room and cried like a baby.
The very next day, as if by magic, all five of Mrs. W's daughters appeared in her hospital room. They had come at a moment's notice from all over the country, leaving jobs, husbands and children behind. That morning, the mood in the room was surprisingly light. The daughers were cracking jokes and I could see they had inherited Mrs. W's sense of humor. I did see one daughter's face crumble once when she thought no one was looking, but she made a quick recovery. When I left the room, I noticed that one of the daughters had posted a hand-written note on the door:
"Outside this door we may fall apart. But inside these walls we will be a source of love, encouragement and support."
After that, Mrs. W was never alone for a single moment. Her daughters kept a bedside vigil, even spending the night in her room. They worked shifts. I would see a different daughter every morning and several of them in the afternoon. After my daily physical examination, a daughter would follow me outside of the room and ask questions. Sometimes the daughter would cry and I would struggle not to do the same.
Today, we discharged Mrs. W from the hospital. She wanted to die in her own home.
As strange as it may sound, there was beauty in this experience. As an Ob/Gyn resident I spend most of my time witnessing birth, not death. For me, the joy of delivery is being in the presence of family love as they welcome a new member. The way that Mrs. W's daughters surrounded her with love was as moving as watching new life enter the world. May we all be fortunate enough to die in the same way.
Goodbye, Mrs. W.
posted by babydoc @ 4:59 PM
2 Comments:
At September 27, 2004 at 6:13 PM,
Kevin Bogart said…
Babydoc, as always thanks for knocking me back on my posterior with another touching insight into medical practice. Will you tell us more about how medical school/rotations/residency etc prepares you for your own emotional reactions as a practicioner? In other words -- it seems like you handled that extremely well, but how much of that was your own good sense vs how well you have been trained? I'd like to think that the medical training establishment does a good job of drilling this stuff into you all, since so many dont have any damn sense. Can you enlighten me?
At September 27, 2004 at 6:54 PM,
Tim Bailey said…
I admire your honesty. What I find sad, beyond the story of Mrs. W and her condition, is that you as a doctor were not "allowed" to cry. There is that sense of control that doctors are trained to cultivate -- perhaps so mush so that eventually many of them actually believe it. It seems like you still have a handle on reality, though, and I find that inspiring. Please don't underestimate how much people appreciate doctors who are willing to display empathy. I would never begrudge my doctor a tear or two if they had to deliver that kind of pronoucement.
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