Sometimes patients become our teachers.
Reaching back some 30-plus years, I can still picture the hospital corridor, the antiseptic smell, the echo my dress shoes made on the white tile floor.
I had on the white coat and tie that was the uniform of the medical student at the time. I had a pipe in my pocket that I occasionally puffed on during rounds. It was probably more pacifier than affectation. We are all ridiculous at the beginning of our careers.
It was the neurosurgery ward and I hadn’t done very much real patient care. Mr. Hubble was one of the first patients I met, and one of the few I remember from that year.
When I met him he had a large white bandage wrapped around his head, was sitting propped up in bed, and this was his first post-op day from a craniotomy.
We chatted a while and I tried to make sure everything was working, without intruding too much. I was pretty sure he wasn’t bleeding to death, as the bandages were still white. Beyond that, he told me about his four young kids, his wife and work. It seemed his brain was working ok.
Sitting at the nursing station, I was trying to figure out the chart. I knew I needed to at least sound like I knew what was going on. On rounds we traditionally started with: “Mr. Hubble is a 45-year-old male, status post-craniotomy for something awful.” Some more digging produced a path report that reminded me why I had taken Latin in college.
Glioblastoma multiforme (Grade 5) was the diagnosis, which didn’t mean much to me when I read it. You perhaps remember Ted Kennedy had this. Pawing through Harrison’s Manual of Medicine that night told me the grim story: Nobody survives or even stays functional beyond a few short months. Egads! How am I going to face Mr. Hubbard tomorrow?
I stopped in to check on him the next morning and he was his pleasant self, happy to be done with the surgery and hoping to take his kids to Disneyland.
After a few days of this, my workload increased and sleep was getting to be a rare and precious commodity. I guess it showed, and Mr. Hubble expressed concern: “Dr. Bucklin are you doing OK? Are you getting enough sleep? Is the hospital trying to beat you up?”
This went on a few days and I finally just had to ask: “Mr. Hubble, you have an awful brain tumor, a wife, young kids, and you are concerned about how well I sleep?”
He did not have a profound answer for me. He knew he was dying and hoped to be strong enough to take his kids to Disneyland for the first and only time. He was glad he tried surgery for his family’s sake, and wasn’t surprised that it was not going to fix him.
Every morning when I saw him he was more concerned with how I was doing, than how he was doing. The irony was not subtle. He got better enough to leave the hospital and, I hope, took his kids to Disneyland.
Mr. Hubble taught me many things that were not on my curriculum. One of them was that not every disease is fixable, no matter how hard you try. He also taught me that a person is much more than his diagnosis. And the patient-doctor relationship is as much about who the patient is, as what they’ve got.
These were all valuable and surprising lessons for a novice doctor. And they were lessons I never forgot.
Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic