The series is a humanities piece, usually devoted to how a patient or personal illness changed a physician's perspective. There are so many great ones, but particularly memorable ones include:
*A young ER doc is on call when she learns that her grandmother (far away in another state) has suffered a heart attack and she struggles to convince her family not to pursue resuscitation so that her grandmother can experience a dignified passing.
*A physician is accidentally stuck with a needle from an HIV-infected patient. 6 months afterwards to the day, having endured the horrible preventive therapy and finally about to be risk-free, she is stuck again with another infected needle.
*A physician (from my medical school) visits the school in Georgia (the country) where masked gunmen massacred the students. He tries very hard to understand the depth of compassion his guide, also a physician, must have had when treating the injured gunmen.
*A physician donates his liver to his alcoholic father and must endure the judgmental comments of colleagues.
Today's feature was no exception and I felt a keen sense of recognition. Because of a subscription issues, I am unable to link to the piece, but I'll quote a passage. It is written by a pediatric anesthesiologist who treated a 2 year old girl dying of rhabdomyosarcoma (a tumor of muscle cells). His responsibility was to sedate her every day for two weeks for radiation. I had a similar patient (same age but very different disease) who underwent similar treatment this summer during my pediatrics heme/onc rotation. I loved her dearly. Anyway, the patient in this week's feature, "Katie," had such aggressive disease that it invaded her bone marrow and made touches difficult. Hence, her mantra and the title of the piece, "Don't Touch Me." I was so moved by the ending:
Each of the next five days was a replay of the first. Katie comes in with her mom, the child in her pajamas. She groans as she sits on the treatment table. "Don't touch me!" is her response to my hand on the back of her head and "Don't" is her irritated cry as I tickle her nose while she is awakening from the "Charlie milk." By that time, we were more than attached to Katie, and I carried her to the recovery area every day for the next five days. I sat in a rocking chair and held her as she woke up, knowing that her candle grew dim. She usually awakened after a few minutes and snuggled in my lap until she became aware that I wasn't Mommy. Then it was back to "Don't touch me" and "I want my mommy" until we could bring her mother in.
On the day before her last treatment I told Katie's mother that I would be at a meeting on the last day of her treatment. I had arranged for a friend of mine, skilled in the care of children, to sedate Katie the next day...
...I returned from my meeting the next week. Katie had finished her treatments. I sat at my desk working on something inconsequential, and my friend came into my office to report. "Well, you must have made a real impression on that little girl. All she could say to me was 'Where is my Dr. Brown?' and 'I want my Dr. Brown.' Oh, and the other thing that she said was 'Don't touch me!'" We laughed as I recounted he many days of "Don't touch me" and "Don't."
I thought back on the last weeks that we had taken care of Katie. After 25 years of caring for sick children, I was taken aback that this 2-year-old - her body racked with pain, dying a slow death, frightened of every white coat - would have remembered me, much less asked for "my Dr. Brown." I thought about what had transpired in my interactions with this little girl. Her whiny little voice - "Don't touch me!" and "Don't!" - and the pain that she felt as we took care of her did not prevent her from forming an attachment that I had missed.-Brown RE. Don't Touch Me. JAMA. 2009; 302:2409-10.
How hard it is to explain how that is exactly how it is. And that's why I chose pediatrics. Kids are magic. There is no greater reward than watching them test the waters of attachment.
No comments:
Post a Comment