The Hand Holder - Reinventing The Doctor-Patient Relationship

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When the residents referred to Dr. Foster as a "hand holder" it wasn't meant as a term of endearment. In fact, we universally dreaded taking care of his patients. It wasn't just his wishy-washy decision making, but also his syrupy bedside manner. Although the patients loved him, we often wanted to run out of the room and vomit.

I remember my last interaction with Dr. Foster. I was a third-year resident and we were rounding together on a patient in the ICU. We examined the unfortunate gentleman. He was on a ventilator and his kidneys and heart were failing.

After methodically writing his note, Dr. Foster and I walked over to the waiting room to talk to the wife. Her eyes were stained with tears as she broke the news. The family had decided to withdraw life support.

Dr. Foster held her hand tightly as he looked deeply into her eyes. He begged her.

"Don't give up yet. I feel like I could have done so much more!"

The wife placed her hand on Dr. Foster's cheek and then embraced him.

"Doctor. Don't blame yourself. You did all you could. It's time for him to go now."

I was disgusted. How had Dr. Foster become the center of attention? He should have been comforting the wife and not vice versa.

I would never see Dr. Foster again. But years later his memory would come clearly into focus at a most unexpected time.

My Favorite Patients

Walter and Sarah were my favorite patients. Although their bodies had withered seventy years of abuse, their spirits were far younger. They bounced into my office with energy and kindness. They greeted the staff and physicians with equal measures of respect.

A year ago, Walter developed a persistent cough. After various remedies failed, a chest x-ray revealed a nodule in the lung. A cat scan was highly suspicious for cancer, and Walter's diagnosis was confirmed by lung resection.

He tolerated surgery well and was plugging along when a surveillance cat scan showed multiple new nodules. Months of chemotherapy and radiation followed. We met in the office frequently to discuss each new development. Sarah worried that her husband was dying. She agreed to the various treatments but wondered if they were doing more harm then good.

Walter, for his part, put on a brave face and took his "medicine" as directed. He also knew that he was dying, but didn't want to leave Sarah behind.

A Doctor's Compassion

As time passed, Walter's disease progressed. He was so weak that the oncologist canceled all remaining appointments for chemotherapy. When he woke up one morning and couldn't get out of bed, Sarah took him to the hospital.

It was with great heaviness that I walked into Walter's room. Sarah was seated at his side. She held his hand as they talked. Sarah stood when she noticed me. I leaned over the bed. A faint smile came over Walter's face.

"Doc. I think it's time to call it quits."

I felt the air leaving my lungs. I doubled over. As I opened my mouth to speak, I couldn't believe what I found myself saying.

"I'm not ready for you to go!"

Sarah was now standing next to me, her arm around my shoulder. The iconic image of Dr. Foster in the ICU waiting room came rushing back to me. Maybe I had been too harsh.

Sometimes when the cards are on the table, it's okay to let your guard down and allow this gentle act of submission. There is a time to transcend the doctor-patient relationship and to no longer be physician, patient, and family member.

We were just three human beings with deep emotional attachments.

And we were grieving.

Together.

About the Author

Jordan Grumet is an internal medicine physician who blogs at In my Humble Opinion. Watch his talk at dotMED 2013, Caring 2.0: Social Media and the Rise Of the Empathic Physician. He is the author of Five Moments: Short Works of Fiction and I Am Your Doctor: and This Is My Humble Opinion.