By Nick Duncan, MD
I still feel new at this, this whole doctor thing, but I’d like to think I’ve learned a few things over the years since starting medical school. Reflecting back, I am reminded of many powerful experiences I have faced and how easy it is to miss the meaning from these moments when we’re caught up in the rush. We’re supposed to be observant; that’s one of the keys to our profession. The restraints of time often blind us in that endeavor. The world is moving at light speed around us; people want answers that come in packages of 15-20 minute boxes. To be a true healer takes more than mere intellect and the correct diagnosis; it takes heart. I’m trying to learn this, and that is why I write.
More and more I find myself thinking about the human condition, this finite time allotted to us on earth. As a physician, I have been given the privilege to see what it means to be human from a perspective that few people will ever have. Over and over I have witnessed those first breaths taken after a baby decides to exit the womb, and I have also stood at the other end of life and watched as it slowly fades away. This is what it’s all about, the joy of new life and unknowns of losing it. In a way, I see us as the stewards of this journey, trying to guide others along the path, from life’s beginning to that last breath.
About 2 years ago I was a lowly intern working on the inpatient medical team when we admitted a critically ill gentleman with multiple medical problems. It never crossed my mind until later that he would never live another day outside that hospital room. He was intubated, on meds to keep his blood pressure from dropping, and losing a battle against an aggressive infection despite powerful antibiotics. When we realized the limitations of our efforts, it came time to have a family meeting. In the end his brothers, his closest family, decided it was time to let him pass. Knowing how much support we were giving his dying body, I knew it would not take long after withdrawing life support. After the decision was made, the family left because they had other responsibilities to attend to. I don’t know what drove their decision, but I couldn’t bear the thought of this man dying alone in a hospital, even if he was not awake enough to completely understand it (at least we think). Other residency-required responsibilities awaited me that afternoon as well, but I couldn’t leave. The wounds of loss were all too fresh for me on that day.
Not more than a few months prior, my own family suffered a tragic loss. Seemingly happy and doing well despite struggling with severe depression, my younger brother Nathan took his own life. I was within minutes of his house on that night, with no idea how my world would be forever changed. Medical school graduation was only a few days away; residency started in a few weeks. It didn’t matter. The world stopped for me. Not a day goes by without thinking about him. I could spend pages of virtual ink writing more about the tragedy of losing a brother so young, but that is for another time.
My purpose is not to dwell on my loss, but rather to show that I learned something about priorities. I feel sad that it took such a tragic experience for me to start learning it. We often find ourselves in conflict between the things we are “supposed” to do and the things we should do.
I was supposed to leave the hospital early on that day for a required element of my residency training. I stayed. I stayed to be with a dying man who I had only met a few days earlier, and though he was not fully aware of what was going on, I could not leave him alone. I will never know what impact I had on my patient that day, but I know that I learned a valuable lesson. Being a healer does not always mean saving someone’s life, or even prolonging it. It means, at least in part, that we stand with our patients and help them find peace as we both face the challenges of life. My intent is not to diminish the importance of the science of medicine, but rather to remind us that it is our human touch that makes it the art of medicine…the art of healing.
Nick Duncan, MD is a 3rd year Family Medicine Resident at the University of Utah School of Medicine. He is also serving as a Chief Resident.
Family Medicine Vital Signs 