Last week, I attended the Orange County Fair. While there, I was surrounded by aisles of fair food, including cotton candy, ice cream, funnel cakes, pizza, hot dogs, and even chicken sandwiches with donuts as buns. After spending a week working with diabetic children as I described in my last post (Pediatric Diabetic Camp), it was hard not to think of all the carbs swimming in these dishes. Abounded by the plethora of treats and fried entrees, diabetic nightmares raced through my mind. Frankly, I feel lucky to eat whatever I want without worrying how much insulin I need at the moment. This is a blessing that I didn’t appreciate until now.
Although I did eat my dinner at the OC Fair, the reason I was there, however, was for the good country music. After the delicious (but probably unhealthy) kabobs, vegetables, and iced tea, I enjoyed Martina McBride’s concert.
One of the songs she sang was: “I’m Gonna Love You Through It”. This song is about cancer. My eyes usually start to water up by the end of the song.
Whenever I hear “I’m Gonna Love You Through It”, it reminds me of some of my patients. Throughout this past year, I’ve been with my patients through their tears, confessions of lost hope, and newly found faith.
One of my memorable patients was Mr. X. I met him almost one year ago while on call at the VA hospital. Mr. X had cancer. He initially came to the hospital to have the mass surgically removed, but his surgery was cancelled because he was found to have pancytopenia with a dangerously low hemoglobin level and platelet count. (Pancytopenia means that blood components are low. Normal values of hemoglobin levels are 13.5-17.5 for males, while normal values of platelet counts are 150,000-450,000.) Upon his admission to the hospital, he was transfused multiple units of packed red blood cells and platelets. His levels rose only slightly. According to the consulting Hematology/Oncology specialists, his pancytopenia was secondary to myelodysplastic syndrome, which means something was wrong with his bone marrow. He was given a poor prognosis.
I still remember that night when my senior resident and I first saw Mr. X. He was lying on an ICU bed with pain, discomfort, and fear evident in his eyes. We took his medical history and asked about his code status and his plans concerning the management of his care. Mr. X told us that he desired to be in as least pain as possible. He was unsure of whether he wanted palliative or hospice care at that point, and he agreed to be DNR/DNI (do not resuscitate/do not intubate). While we were speaking with Mr. X, he confided to us that he had a falling out with his church several years ago and felt troubled about it. My resident comforted Mr. X and was able to alleviate some of his worries. After examining Mr. X, my resident left me to examine him myself. While in the ICU, I openly asked Mr. X if I could pray with him, and he willingly accepted. When I finished praying a few words, he was crying. He told me that he did not remember the last time he prayed, and he couldn’t believe that anybody wanted to pray for him.
As I followed Mr. X, I got the chance to connect with him for a few minutes each day. He mostly wore a flat, expressionless face, but he seemed to brighten up when I chatted with him. He was even able to tell me a few jokes and laugh with me. Unfortunately, his health was noticeably deteriorating each time I saw him. I could tell he was in constant pain even though he would tell me he was okay. His hemoglobin and platelet levels continued dropping, and subsequent transfusions had little improvement. I held his hand and prayed with him every day, and he constantly told me how much he appreciated spending time with me. He opened up to me, telling me how ashamed he felt because he was supposed to be a “strong military man”, yet he was tremendously afraid of dying. Mr. X said that it was difficult for him to be cognizant of his impending death, and he wished his mental status were not intact. I did my best to reassure and comfort him. Upon my sharing of his fears to our team, Mr. X was offered chaplain services, but he refused it. He told my attending physician that his time with me was already good enough for him. That meant a lot to me. Although I am no expert in spiritual matters, I was and still continued to be amazed that God could use me.
Knowing that Mr. X would die soon was heartbreaking for me too. I knew my time with Mr. X was also limited because I was leaving the VA hospital the next week and switching to another rotation. Before moving on, I let him know that I would be working at a different hospital the following week, but I would still think of him and pray for him. I also told him that spending time with him had helped me grow spiritually as well. Although Mr. X’s awareness of his grave situation was disturbing to him, I was grateful for the opportunity to thank him for touching my life. I told him that I would always remember him even though I would not be seeing him any longer. Because of my connection with him, I am now more inspired to reach out to my future patients. During our final moments together, we both had tears in our eyes. Through his pain, Mr. X told me that he believes I will be a great doctor, and he promised to keep praying for me. (Since I am still learning on my own spiritual journey, I always ask my patients to keep me in their prayers as well.) He told me that he was thankful that God put me in his life during his time of need.
About 3 weeks after I said goodbye to Mr. X, I went to the VA to visit him again. Unfortunately, I found out that he had passed away. Although his medical condition did worsen, I was comforted by the fact that I helped heal him and brought him closer to God. My patient also reminds me that I can make a difference in people’s lives, and he is not my last patient.
As busy medical students and healthcare professionals with little sleep and many exams, it is unfortunately easy for us to simply address their physical medical problems, almost to the point of ignoring that our patients are people who need to be loved and cared for in more ways. Through my personal experiences with patients over the past year, I’ve seen that healing emotionally and spiritually are equally as important as attacking a disease process. I find value in treating patients with incurable and progressive diseases, even if I can’t promise them a “cure”.
Very recently, I’ve found myself seeking God to help me through personal unexpected challenges. Sometimes, things in life don’t turn out the way I plan, but that does not mean that God loves me any less. If anything, I feel more grateful for the blessings He has given me, and I am thankful for the experiences He has given me to reflect upon. I truly believe that God won’t give me any challenge that I can’t handle, and I am comforted by that fact. As one of Martina McBride’s other songs says (that I was hoping she would sing at her concert but didn’t): “God is great, but sometimes life ain’t good/ And when I pray, it doesn’t always turn out like I think it should/ But I do it anyway”. Well, I am looking towards a better tomorrow. On this journey, I hope to continue healing my patients and myself. Please pray for my patients and me!