Helping Patients With What They Need

“How are you doing, Mr. B?” I greeted my patient as I was walking into his hospital room.

“Not good,” he replied. I noticed tears welled up. “They said that the (sacral) wound is not healing. I am not getting stronger. I am not getting better. What is the next step? Is it time for me to plan my own funeral?”

Mr. B is a man in his seventies. He was diagnosed with multiple myeloma more than ten years ago. He responded well with treatment. He was independent and was doing well until about a year ago, when he started to have progressive weakness on his legs. He also developed pain on his back. That was around the time when he was found to have recurrent myeloma. He was restarted on chemotherapy and had excellent response to his treatment. However, his weakness did not improve for unclear reasons. Due to long hours of staying in bed, he developed a pressure ulcer so deep that it was invading into his rectum. He had to undergo a diverting colostomy to allow the sacral ulcer to heal.

Mr. B had just finished discussing his ulcer situation with the surgical team before I walked in. Although the surgeons proposed another approach to treat the ulcer, Mr. B believed that the ulcer would not heal, he would not get stronger, and he would be bed-bound for the rest of his days.

Many of us have the default thinking that things are not going to work out no matter what we do. Is that true? Do you know that for sure?

I replied, “This new approach to treat the ulcer may work. We won’t know until we give it a try. Instead of thinking that it is not going to work, what about thinking that it may work?”

“You are so optimistic. I know you really care about me,” Mr. B said.

We then had a discussion about how we get to choose our perspectives. We first need to know what we are thinking and how that affects our feelings. When Mr. B thinks that nothing is going to work to make his ulcer heal, he feels sad and hopeless, especially when he was an independent person who used to drive himself and live alone. What if it was possible for the sacral wound to heal? What if it was possible for Mr. B to get stronger and walk? That generated a feeling of hope and possibilities.

I am grateful that I had the opportunity to spend the time with Mr. B and let him know that he is not alone. My message to him is that someone cares about you and wants the best for you.

The biggest reason for me to become a physician is to help people, in a way that makes a difference in their lives. It is about the connection. It is about shining in a ray of light through what seems to be a gloomy situation. And I am talking about a realistic and possible hope as opposed to the unrealistic expectations.

To be able to care for others, take care of yourself first. You can only give what you have.

Take care of yourself so that you have the physical and mental energy to take care of others without running on empty fuel.

When you love yourself, you can love others.

When you do not feel alone, you can let others experience your love and care.

You see them. You are there to listen. You are there to help. You are there to give them hope – realistic and possible hope.

I always believe that, as physicians, taking care of a patient is more than just treating the physical diagnosis. When we are taking care of ourselves, loving and caring for ourselves, we can better take care of others. We can be more sensitive to what the patients are really saying or what they really want (besides getting their physical disease treated).  We can make a difference, and sometimes we do not even realize how much impact we have on someone’s life.