Patient was telling me that his wife of over 50 years had passed away. He had gone out and gotten a wheelchair, which she only used three times. He said, "Of course, the last time she came home, I carried the urn in my hands." I was just about to listen to his lungs and had to just stop and recalibrate for a second. Happy holidays, everyone!
I recently had a very sweet patient with terminal cancer transition to hospice. we had a little heart to heart, and we were talking about our hometowns which were very close to each other, sharing our favorite shops and restaurants. He wished me well during the rest of my residency and said “you know where to find me,” in reference to the cemetery where he knew he was headed. 💔💔
Ah, fuck. I was a PG1 on a resp ward, and had this lovely fella with some horrible cancer who quickly became my favourite patient.
I was young and dumb and, of course, dating a nurse on the ward.
Our favourite patient hated hospital food, obviously, so we used to bring him in something from home. We’d cook up the night before, and bring what he wanted to order. It was supreme favouritism, but he was the nicest guy and had been in hospital forever. He didn’t drink much except orange juice; I’d always either steal him some from the fridge, or get some from the cafe.
He had a whole collection of motorbikes, and him and I would sit and chat about bikes and cars and planes. He told me he’d get home and invite me up to his farm! He had a dirt bike set up he used to rally around himself lmao - absolute legend. Turned out he was pretty wealthy, and never had any kids. I felt he kinda took a shine to me. The job was busy and I often wouldn’t get a break, beyond just sitting chatting to him for a few mins over a cup of tea.
It was a long weekend, and he got a pass to go home. He’d rented a new bike to take for what he said was ‘one last spin’. I, for once, had the weekend off.
I came in the following Tuesday, and say he’d checked back in. I couldn’t wait to see the videos he told me he’d take!
We had this board in our office. A rather ominous: DEATH CERTS NEEDING DONE: and there was his name. My senior, who loved this man as much as I did, just sat and shrugged and told me he was dead on the ward round.; then, he tells me, “Oh, Adrian left you something.” And gives me a little model motorcycle he’d brought back to hospital for me.
He signed the death cert and then that was it. We did the ward round and that was it. Day goes on. His bed was immediately filled by another equally deserving patient who, by someone else and other stuff, would be equally-loved.
And now I’m my senior. Non-plussed. Unbothered.
This job does weird things to you.
I still try to remember my favourite patient and the motorbike, sometimes.
2020 and I was a resident in the MICU, we had a patient who was flown in with covid ards. ~65 with no other medical problems besides BMI 28. I had been off the previous week and was on for the next 14 days. I was anesthesia so the attending had me admit/write the H&P and then induce and intubate. Her husband was her only family member alive. They were from rural NM and he didn’t have any family or friends and he was mostly blind. I called him at the end of my shift every day after sign out to update him and chat. He would tell me stories about her and about their life together from being married for almost 50 years. It was always at least a 45 minute phone call because he was long-winded and there was no way for him to visit his wife. He would call me “babe” and talk about their ranch or he would give me relationship advice or he would occasionally just cry on the phone for 30 minutes. I admitted 15 covid ARDS patients that particular block and none of them did well. When she died a few days after I rotated off, the resident that took over for me never called him because they knew how longwinded and challenging he was on the phone and her husband heard the news from a random case manager RN for planning what to do with her body. I tried to call a few times and it always went to voicemail.
I still try to be patient and let people talk a bit more than what others might tolerate. Maybe that’s a weakness maybe it’s not good. But also maybe it lets people feel a little bit more heard and cared for.
Medicine is weird man, what do we do with these experiences?
You grow, you maintain compassion, you use it as a light or souvenir when going through dark times.
It's human nature and we are all human. Many become numb, or callous. Doesn't mean they didn't care. But as long as it doesn't wreck you, it helps to remember even the sad cases. Because maybe you were a light in their dark times, and you keeping that compassion, weakness, whatever, may help someone else.
My favorite surgeon was also my worst rotation. We would finish thoracic cases and then 6 or 7pm round on all his inpatients. Id try my best not to fall asleep leaning on trashcans and walls as he would spend 10...15...20+ minutes talking to patients and their families. Some pre op, many post op. Not bad until you realize it could be 2-3 hours of this.
But I realized, if I ever was going to see a surg onc, or thoracic surgeon...I'd want him. So I try and be like him, but some better boundaries for work and family balance.
Sorry it became so long winded. P.s. don't get a esophagectomy...I'd rather die choking on a pierogi than on my own saliva.
Dude, I almost started bawling in a visit earlier this week because my patient, who had just lost his wife of decades, stopped all conversation to show me a video he had recorded of his Xmas lights. Apparently, she was a huge Xmas lover, so this old fella took a shaky phone video of himself standing in front of the display, telling her that he had put the lights up in her honor. Damn, tearing up just remembering it. Grief is a powerful little fucker.
I got teary reading this
Yep, actually crying now. Almost did in the middle of the night this week when my patient in his late-80s wept after being informed that his new “spaciness” was a brain tumor that will end his life. His relief when his wife arrived hours later made me feel more single than ever, yet simultaneously really, really happy that he’d had such a good run and someone to lean on. It was beautiful. Nauseatingly painful, but I felt lucky to witness the humanity of the moment.
why is this blurry 😭
I was first on the scene to a car wreck involving 5 kids. Driver was 17, front passenger 15, and three in the back seat ages 12, 10, and 9. Oldest two up front self extricated with minor injuries, but the kiddos in the back seat had been unrestrained, and the youngest two were bad off. Car had been T-boned in an intersection. By the time I got to the 9 year old who was in the middle back seat, she was posturing and her breathing was irregular, vitals all over the place. The 9 year old had signs of internal bleeding, and a pneumo I darted her for, multiple fractures, the works. We did what we could on scene, called in two birds for the youngest two and transported the other three by ground. I was pretty sure she wasn't going to make a meaningful recovery, if at all.
10 months later I am working and get told I have visitors at the fire station. In walks the little girl with her parents, carrying cards, drawings and a cake, to tell me thank you for saving her. She had a huge uphill battle, and still some minor deficits, but she was there and happy. I was too choked up to eat the cake. Made a lot of what we deal with in EMS worth it though.
You will be happy to know that when my 17 yo got his first speeding ticket the other week, I went absolutely nuclear on him, because more so than he could have hurt himself, he could have hurt or killed someone else's kids. I was livid and almost made him take his license to the shredder (but I'll be damned if I have to drive him to work to pay for it).
Like, yes, I too was a stupid teenager who drove way too fast and was a terror on the roads. But I'm dad now, so I get to lay down the pain when he does it.
I think that's awesome! Don't forget to give him the DUI alcohol and drugs talk too, as well as never driving his friends that are unrestrained in his vehicle.
When my oldest son was 17 he did a few ride alongs with EMS. He gets it now, and is incredibly responsible. I gave my kids a get out of jail free card too where they can call us, at any time and no questions asked, should they find themselves in an unsafe situation or without a suitable ride home. Funny enough, it makes them think twice about getting into situations where they may have to call us and they feel more comfortable being open about where they go and what they do.
We have done this from the time they were allowed to go do things on their own, and it carries through today.
Text us our family codeword and we'll be there, no matter what, no questions asked, we'll deal with any issues at some later point.
This gave me chills. Thank God for you.
I needed to read this today. Thank you.
My mouth literally fell open when I read "In walks the little girl"!
A happy one from me.
Background story: My grandma and I were very close. She died the same day I graduated from High School. She always said she would make it until I graduated. My uncle found her dead the same morning. Needless to say, I had a horrible graduation day.
FNA clinic, 20 years later. A nice spring day. I had an old lady patient, quite similar looking to my grandma. She had a supraclavicular lump. She looked me in the eyes and said ”you know, I am old. But the only thing I really want is to keep myself alive until my granddaughter graduates High School”.
Still not sure how I kept from breaking down in that room, but I did.
It was a ganglion cyst - one of the few diagnoses a pathologist in FNA clinic can be sure of without staining or preparing the sample in the lab. Immediate diagnosis.
So, I got to tell her that at least the lump would not stop her from attending her granddaughters graduation. Still get teary, thinking about it.
Had a very sweet late thirties teacher come in with a pregnant looking belly from ascites. She had terminal cancer and was hoping for a para so she could be there for the first day of middle school without as much pain or any obvious signs. She was in the process of getting her phd in education so she could have that degree on her tombstone and make her kids proud. Only time so far in my career I have cried in front of a patient
I’ve been in practice for about 20 years. I lost my wife about 2 years ago, so my regulars know. It’s been an interesting bonding that I have with my patients who also have lost someone. I think cry in front of my patients about once a week.
If your patient is not looking well, you may see if she is ok with talking with her program about accelerating her phd.
Hmm. Reminds me of a happy version of that. We were bringing a patient home to her second floor (no elevator) apartment after a hospitalization, where her husband was waiting for her. When we got her into the apartment he exclaimed about his wife "arriving special delivery!" I loved to use that line when I coukd after that.
I had a cancer patient with a trach who was constantly in and out of the hospital. Her only form of communication was through writing on a white erase board. We both knew there was not much else that could be done for her. I sat with her for about an hour as she wrote to me on a board about her mom and her brother growing up. And how she was excited to meet them in heaven. She was upset that her living family was trying so hard to keep her alive. She said maybe she’d go have a beer before the end (hadn’t drank in years). She told me about her pet duck and her cats. And worried about what would happen to her mom’s antiques. When we were finished we were both in tears and she gave me a hug. She thanked me for actually taking time to communicate with her. She said she lives in the middle of no where and hasn’t been able to talk to anyone in so long. She passed shortly after. RIP ❤️
Met a patient long ago that lost a child just as her other child was entering hospice. I still cry every time I think about it.
Jfc, why does life have deal shit hands to some people
Aaaaaand I'm done with this thread tyvm bye bye
Every time I have yo ask about martial status (Fucking Medicare Questionaire) and have to update status I just... drop an octave and apologize.
At this point I've met more than half my regulars significant others and knowing they'll never be back is always a fucking suckerpunch.
Another one for the rewarding pile:
An elderly patient I last saw about 30 months ago was admitted with a new provoked PE a couple weeks ago. His wife called the office to see if they could get in with me for outpatient follow-up because, as they told my secretary, they'd really appreciated the care I provided.
Unfortunately in the interim he got readmitted yesterday for a significant bleed that was never life-threatening but very terrifying. I happened to be working on consults and since I knew he was in house I stopped by for a social visit. I popped into the room while another team was rounding. He saw me and said, "There she is. I love Dr. Natz."
With a laugh I said, "I love you too." He said, "No, I'm serious, you're the best doctor, you always listen and take such good care of me." And then he started crying!
I almost wasn't even going to stop by, I was busy, notes to write, blah blah blah. But those extra few minutes meant so much.
Not just the sad moments, but I think the “feel good” moments are why we go into medicine. I saw a patient earlier this week for pregnancy confirmation. She was someone who came to me initially for infertility workup. I discovered hypothyroidism, PCOS, multiple ovarian cysts and a fibroid on ultrasound. She just had so many reasons to be unable to conceive. I referred her to OB for the fibroids and cysts. And she came back to me 3 weeks later and she was pregnant! She came running up to me and hugged me. I was SO happy for her.
Three weeks????
The cysts were morula
Her cysts and fibroids are still there, so I sent her to high risk OB. Hopefully her pregnancy is smooth and she can deliver despite the fibroid, if it doesn’t grow.
Her thyroid is still uncontrolled since tsh and t4 levels won’t normalize in 3 weeks, so that’s another reason she’s higher risk.
That's part of being in medicine, sadly a part that reminds us we are alive and helping people out of their issues.
I had bad moments where I cried too, but I treasure the good ones where I also cried of joy.
I have talked here about a 16yo with a terrible heparic injury that against all ods survived and made everyone cry at the ICU when she talked with her mom for the first time by phone after months of vent.
I also remember my first complicated patient that ended up in vent after an urgent hemicholectomy because she was septic. I cried when I saw her coming to a control walking with help...not only because she was walking but because we really thought she wasn't gonna survive that night.
Those are the moments that makes you feel alive and that shows you that the effort you have made had helped out...and that you don't have burnout
And some people think we go into health care for the money. Pfft!
Have a very sweet elderly gentlemen that's been my patient for several years now. His wife had dementia, this was the first year she wasn't with him for his eye exam. He's one of my favorite patients, he's always a delight to the staff, just very kind and has a very calming presence, like a real-life Mr. Rogers. The way he interacted with his wife was always wonderful and patient and kind.
I asked how she was doing and he let me know she passed away right after Christmas last year. She had a few "really good days" and got to see her whole family again, and basically lit up for just a few days. Then she passed quietly in her sleep a few days later. Still brings tears to my eyes thinking about it. He very frankly said she hadn't been herself for a long time now and he was grateful she got to have one more Christmas with her family and was able to leave with that being her last memory.
Auuugh this one got me ಥ‿ಥ
I once had a patient come into my SNF in order to get PT/OT so she could get strong enough to do chemo/radiation for her breast cancer. She was a lovely but very anxious woman with a wonderful family and friends coming by daily. She started having some medical issues that kept preventing her from going to therapy. Eventually, on a hunch I ordered the right test and found out the cancer had metastasized and was terminal. She had to be sent back to the hospital not long after due to the complications. she then went onto inpatient hospice and passed away
Working in SNF/LTC/Hospice, I've seen a lot of patients die but this one hit the hardest. At the time she was really going downhill, my facility was temporarily closed to new admissions so as all of my short-termers discharged I had less and less to do each day, so I spent a lot of time talking with her about anything and everything because it helped her anxiety. She is probably the closest I've even been to a patient and I think about her a lot still. When she passed, her husband called the facility to let us know because he knew how many people there were rooting for her
I'm in elderly care and currently in hospice. Some of the stories there are heartbreaking, but some are also accompanied by a reminder of how fragile we are as humans.
Just hours ago, I had a patient burst out in tears just by asking what his goals for the future were (post-hip surgery and expected to make a full recovery). Meanwhile, the hospice patient literally 2 floors down kept cracking jokes at me about how he hasn't felt as good in weeks with his new dose of fentanyl.
I think we sometimes need to remind ourself how we're all human, and how it's exactly that humanity that makes us good at our jobs. The moment we lose that, we lose sight of what it really means to be a doctor.
I don’t find these stories sad. I quite enjoy them. I love hearing about lives so well lived that it allows those who are left to remember. Everyone dies, not everyone lives a good life. I want my wife to have those stories. I want to be remembered by those I loved.
I find it sad in a way but I also don't find it the kind of sad that's painful if that makes sense.
I have a lovely patient who I’ve been taking care of for a few years, and she moved in with a partner and quickly found out he’s an abusive piece of crap. She’s been trying to get out for the better part of two years and finally got a place and is moving out soon. We’ve had constant safety planning, while also dealing with all the medical issues coming up as she ages.
She asked if she could give me a hug at our appointment and I said absolutely! I’m gonna be riding that high (as long as she gets safely out and maintains her safety) for weeks!
Sometimes it’s good stuff, sometimes it’s difficult stuff, and sometimes it’s in the same day. It’s good that we still feel things!
A couple of months ago, while I was working a night shift in the ED, a young woman was brought in vitaly unstable, with decreased consciousness and severe shortness of breath. On auscultation, she had clear signs of pulmonary edema. She was accompanied by her sister and her young son, who was too little to understand what was happening to his mother. Watching him ask about her, completely unaware of how unwell she was, was heartbreaking. My eyes filled with tears thinking about the little guy, how his life is not going to be the same anymore and I found myself lost, not knowing what to do. No matter how hard you try to suppress your feelings for your patients, they still find a way to creep up on you at times.
I feel extremely privileged to have a job that hits me on a deeply emotional level from time to time.
I had to try and comfort parents who learned their child had a devastating stroke with brainstem herniation last night. And try and keep him alive as they took time to process it 😭
70 Yo Bedbound, blind, autistic, nonverbal patient who was admitted to my service for pneumonia. The first time I saw her; she stretched out her hands to grasp mine and then kissed them. Her sister and brother in law said that is how she says thank you. I cried that day because I dont think I have ever received such a genuine and heartfelt thank you. The sister and brother in law had been taking care of her and another cognitively impaired sister for 50 years and refused placement for the patient. They said they would take her home and continue caring for her because that's what family does. I swear I started tearing up right there and then. Sometimes, you meet the most angelic and beautiful souls who are too good for this earth.
Mine was earlier this year... a younger (20s) patient, very ill. From another province, nobody local for support. I asked her if there was any family we could try and call before transferring (rural, she needed to go for specialized care at an urban centre; poor prognosis either way).
She responded, "I have no ancestors, I'm an orphan in this world"... ... ...
This was RIGHT at the time my last grandparent was passing away. They were my last living family member... and I realized, I'd be her in about a week- no ancestors. I do have the caveat of an awesome friend network, but, those words were like a physical thump to the gut.
Damn near broke into tears bedside, that pt got a hug, and hand holds until she was ready to go. I cannot imagine how lonely and terrified that young woman was. </3
A PT had suffered the loss of a 23 weeker. They had the baby cremated and buried the ashes under a big flowering bush; forsythia or something.
She was telling me about this and said "We put her under the bush and every spring she comes back to me. I had to keep it together til I left the house and bawl in the car.
Those moments stay with you. Bearing witness to that kind of love and loss is heavy, and it is okay to pause and feel it. It is one of the quiet privileges of this work.
I’ve been caught in the feels 1.5 times.
The first was in med school, psych rotation, a guy my age who looked like he could have been my friend, was in for a first break psychosis, he kept begging me not to add meds because he was worried it would affect his music composition abilities, then later tried to escape through the ceiling because he was trying to save a girl he was hearing being sexually assaulted. His dad was an exec lawyer type and I remember the day he came for an update and just collapsed into a sobbing ball describing the promise and dreams his son had (NYU student).
The second (half) time was the elderly husband of a long term patient of mine who had emptied out their life savings on medical care for her terminal illness. Somethings out how desperate he was to do anything he could to make her better.