He was about my age, coming in to the ER with a fever. He had lymphoma, and was a week out from chemotherapy with the expected drop in white cells that rendered him immunocompromised as a result. I was a second year resident in emergency medicine at the university hospital where he received care.
Despite difficult IV access and discussing the unpalatable need for admission and antibiotics, there was also a wry sense of humor that hung over our entire interaction. It sucked what he was going through, but his was a guy I'd want to hang out with outside of the ER.
Up until that point, there was a professional distance I'd maintained with patients - I thought it was important to keep work and life boundaries clearly delineated.
Colleagues had been less dogmatic. My little sib, a year behind me in residency, called a bioethics hotline operated by our professional society to see if it was permissible to call the attractive flight attendant who'd left him her number after treating her sprained ankle (it was, and he did).
I changed course and called my ex-patient a couple of weeks after I knew he'd been discharged, asking if he wanted to meet for coffee and talk over what he was going through. He was happy to make a friend during a lonely period of chemo, and it helped that I had an irregular schedule who could meet him in the middle of a Tuesday.
And thus, partly thanks to the fact that my company occasionally seemed preferable to watching reruns of Starsky and Hutch or Love Boat when the rest of his world was at the office, we grew close.
When a writing group I was part of proposed an assignment along the lines of, "What would you do differently if you had a month to live," I asked him how facing the reality diverged from the theory. (He reported it was less glamorously tragic when you actually had to live the problem.)
He introduced me to his girlfriend over dinner; she was a nurse he'd charmed when he was a patient on her oncology ward. It was his way of letting me know he had more game than I might think, an implied wink and nod.
We met every few months for the remainder of my residency. He and the nurse girlfriend came to my farewell party when I graduated residency. We kept in email contact when I drove out to the East Coast for fellowship, and he filled me in on his life milestones as they rolled in.
He and the nurse married.
He had a recurrence.
He found religion.
Then, on a spring day when I was ~2500 miles away, his wife sent me an email informing me that he'd died.
This May marked 17 years since his death.
I email his wife annually on the anniversary of his death to reminisce. We exchange photos of our kids, living near enough that we are bound to run into each other, far enough that we haven't yet. She is happily remarried, grateful for her time with my friend, fortunately able to rebuild after her loss.
I've never befriended another patient.
Comments 8
But it was a good thing you did that it seems. Helped another human through a tough period. I often wondered about friendships with my coworkers since I was everyone’s boss. They rarely went past a superficial level because I controlled their pay and their promotion chances. It’s not like being their doctor but it still had some inherent conflicts of interest.
Author
It’s interesting you note that inherent tension. I found myself walking down Newberry St. in Boston on a cold winter day when I recognized a passing face as a friend of a friend from college. He was nonmedical, and we had no overlap in our lives back then. He was new in town, and we exchanged numbers.
When we met for a meal later in the month, he told me of his early success as a young executive in a fortune 500 company, and how that had changed his relationships because thereafter he was worried that potential friends might have extractive goals in mind. He was excited to hang out with me because, “This is great – there’s nothing you could possibly want that I have!”
In this case, my position as a trainee didn’t seem to offer any undue influence, so it was more two people who spent time in the same surreal space that he inhabited as a patient and could understand his low moments that much more easily. And although it began in the ED, it grew into any other close friendship created during a time of intense solitude – a source of welcome companionship for both of us.
I think “befriending” patients at some level is one of the most interesting aspects of medicine. Anesthesia is a business much like ER where the interaction is quite defined. Like an ER doc, I had about 3 minutes to gain a patients confidence and trust before he/she was whisked off and their life was placed in my hands. Pain medicine OTOH was a business where I cared for patients sometimes for decades and got to know them. Anesthesia patients often dropped off boxed cookies some time post-op and I would say hi if I saw them at Walmart or my daughters dance class or the post office. Pain patients brought me produce they grew in their garden or stuff they baked, a different level of intimacy. The real reward was when I would meet a stranger and they would “know me” and show gratitude because I took good care of their mama. Secondary effects like that lets you know you’ve been highly effective in helping another person. It is around things like that causes community to form.
We all die. It’s how we live that matters.
Author
That’s a perfect encapsulation of the short- and long-term physician-patient relationship.
I’ve had an arm thrown over my shoulder at Costco by someone proud to tell me they finally kicked those pills; a thank-you keychain or bottle of wine in my box at work; my child’s dance teacher who misted up when he realized it was I who had cared for his ailing mother that late night in her final months.
This was the only person who ever departed from the script that separates inner sanctum from game face at work, however.
I’ve had several “departures”. One party we went to at friends house had about 50 people there. I was brought up short when a couple hours into the festivities I realized 48 of them had been my patient at one time or another. The benefit of a long career in the same town.
Author
That’s one small town!
I don’t have any stories but just came here to say that I loved this post. Very touching. What a special relationship!
Author
You are a ray of sunshine whenever you visit, Dawn. Thanks for the kind words.