PCM Reflection

By Janaki Patel

It is in fact true that each physician and resident has far too much on their plate, probably a byproduct of systemic healthcare concern, however, each person still visits their patients at least once a day. Five minutes sitting at the bedside is equivalent to 30 minutes at the door – one of the first lessons we were taught in PCM. The biggest lesson I learned, however, was the importance of making a connection with each of my patients. It wasn’t about how much time I spent with the individual, whether I spoke their language, or whether I sat down, that made them trust me or connect with me – I couldn’t always do all three things for each patient. So what was the secret – I showed them I cared.

My first patient was a Spanish- speaking pregnant woman with possible appendicitis. When I first met her, I was nervous about my performance clinically, and I was embarrassed about my broken Spanish, that has been sitting unused in the cobwebs of the attic of my brain. It’s funny though, how the patient doesn’t mind. I tried English at first, then feebly uttered, “ Usted Habla Espanol senora?” I still remember her smile months later. I went on, encouraged by her acceptance and enthusiasm for some familiarity, in the world of foreign uncertainty she was currently swimming in. A week or so later, we had done nothing therapeutically but pain management and could not provide any definitive answers – her eyes fearfully darted to her stomach where her arms were wrapped around, almost as if trying to cradle her unborn child, as the resident explained to her what had happened and how we would manage. When I returned later and re-explained in Spanish the fear remained, however, a veil of uncertainty had finally been lifted it seemed. Before she left, I told her in my broken Spanish that I wished her the best, was sorry we could not give her the answers she had hoped for, but I hoped she would soon be able to hold her child. She had been staring at her stomach, but she looked up for a moment and held my gaze with her eyes. She gave me a small smile and feebly uttered, “I will not ever forget you.”

There is communication that spans far beyond the pragmatic obstacles. Humanism. The word itself implies a species-wide union – though the path to is its expression is not as well delineated as we’d like. She was my first patient. I thought that it was the Spanish that added comfort, but then I encountered my first Arab-speaking patient – along with the telephone translator. To add to the difficulty, I had to explain a probable slipped disc for which the hospital would not do imaging but rather refer her to outpatient neurology follow up – a difficult task to explain in English. Short sentences, some pencil and paper, a blue translator phone, and an hour later, we finally made it to a place of understanding. I came home an hour late that day but could not help but be energized by the new connection I had made. My thoughts returned to her last words that entire day – she looked at the me with her vibrant, large, bold eyes, took my hand in between hers, and said, “I thank you.”

Even when you can’t help, you can. I came into this profession for these moments. After the countless obstacles and tears shed getting to this point (with no doubt, many more to come) – these patients have given me more than I will ever be able to give them – connections to the world. It wasn’t language – it was reading their humanity and the emotions that make us human, that allowed me to connect – after all, at the end of the day, we are all human.

The art of understanding our own – Humanism.

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