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When Death Approaches

When the Patient is my Mother

As many patientís stays begin, so did my motherís - in the back of a medic van. She was in severe pain and I felt incredibly grateful that we have a system of paramedics that can offer strong relief for pain just as they treat many of the more graphic emergencies.

Then she was in the emergency department, the place Iíve written about for the past ten years. While it was completely predictable what was going to happen, it was still weird being in a room looking out, hearing my partner say the same general words that I would usually be saying; trying to balance the right blend of hope with 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, too much better than my siblings in the room, just how close to death she might be.

She survived the surgery. After a couple 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, her partially paralyzed left side - all the 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 very 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 learning during this time has been observing the small aggravations that sometimes occur in the course of hospital care. This experience of what itís like Ďon the other sideí reinforces simple lessons that will make me a better doctor.

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

SAnother 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. The overwhelming emotions are gratitude and admiration for all of those involved in my motherís care. In todayís hurried world it is unfortunately common that few people show formal appreciation for the care rendered 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 are plenty of challenges ahead for my mother, myself, and the rest of the family, many lessons to be learned.

What is the best way to be a son whoís also a doctor? She doesnít 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.

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