A few years ago, I was sitting in the labour and delivery room of Mount Sinai Hospital in Toronto, waiting for a patient of mine to deliver. One of the nurses poked her head out of a delivery suite asking for help. A patient who had been pushing was not feeling well. As I walked in, the patient suddenly lost consciousness. Her heart stopped beating. I began resuscitative efforts while the patient’s obstetrician delivered the baby. By the time the arrest team arrived, the baby was born and the mother’s heartbeat was restored. At this point, her care was transferred to the team and I returned to my patient. I thought that this was the end of the story.
Three weeks after this event, an elderly patient of mine came to the office complaining of lower back pain. She was an apparent breast cancer survivor, having recently celebrated her fifth year of remission. After a careful examination, I concluded that she most likely had mechanical back pain. However, because of her past medical history of cancer, I ordered an X-ray of her back in order to ensure that the tumour had not invaded her bones. She never went for the X- ray. A few days later, I was notified that she had gone to Mount Sinai because the pain had become unbearable. Radiographs showed that the cancer was everywhere. Because it was compressing on her spinal cord, she could not walk and was admitted. It was clear that she was not going to survive.
It is not easy to tell someone that he or she is going to die. I will never forget entering her room. Her eyes told me that she knew. Yet I was struck by how happy she was to see me and how comfortable she made me feel. For her, I was a familiar face in unfamiliar circumstances. For me, she was a patient I had tended to for some time and was now about to lose. It did not seem fair. Suddenly, in hushed tones she drew me near her and said: “You know, the woman lying in the bed next to me—she’s going home tomorrow. She almost died in childbirth, but now she and her baby are going home.” I glanced beyond the curtain that divided the room and peeked at the woman sleeping in the bed. It was the patient I had help resuscitate three weeks earlier.
The paths of life intersect in unexpected ways. At that moment, I realized that in this room lay a microcosm of what we do as family physicians. We are there at the beginning and at the end. Our work is
about life and death and the time in between. There are some things
over which we have control and many things over which we do not. Yet,
we are lucky because we share moments of sublime intimacy with our
patients and can touch one another in profoundly precious ways. For
all of this, we are truly blessed.
http://www.nationalpost.com/todays_paper/story.html?id=880373
