Our patients are not just a mass of symptoms, vital signs and diagnoses. They are more than that. They are humans with real life stories and if one bores just a little bit, the accounts are funny, uplifting or sad.
Anesthesiology is not known for promoting contact with the awake patient. My patients are mostly asleep or really sleepy and forget me once they wake up. I am a victim of the very drugs I administer. Yet, one can still capture a lot during a preoperative visit. The time for “preops” is not infinite, but there is always a few times in a day where things slow down and a visit lends itself to learn more about a patient’s life. It gets even more interesting when there is family present.
I was visiting with a patient, C.H., with advanced colon cancer who was presenting for a colectomy. She was in her mid forties. In her room were her 2 older sisters and their mum. Her dad had died few years earlier and she had no brothers. My interview suffered from constant interruptions by all of them. Every answer C.H. gave elicited a comment from a sister or the mum. Sometimes they answered even before she had the chance to open her mouth. It prolonged the interview but I was enthralled by the family dynamic. One sensed a certain degree of affection that was expressed rather caustically.
Things came to a head when I asked C.H. whether she smoked or had ever smoked. Her response was that she didn’t and had never smoked.
That is when her oldest sister piped up, “You liar! Remember when you were 15 and got a pack of cigarettes?”
Their mum went, “What?”
The oldest sister continued, “She hid in the crawl space and smoked.”
C.H “No, I didn’t”
“Yes, you did!”, the sister insisted.
At this point, my eyes are darting from C.H, to oldest sister to mum.
The mum had an incredulous look on her face. She went, “You idiot, you could have burned the house down!”
C.H., “But I didn’t” – I guess she did smoke under the house in the crawl space after all.
The mum went on, “If you were not sick, I’ll lay you in my lap and give you a good spanking!”
They must have seen the smile on my face because they all burst out laughing. I laughed right with them.
At that moment, the fear, pain and anxiety vanished from the room.
A mother and her daughters shared a laugh.
For a while, they held on to something very fragile that was at the risk of being lost for ever. A bond between sisters. A bond between a mother and her daughter.
As I walked out, I couldn’t but admire the love that one felt in that room. I knew her prognosis was poor and that broke my heart. However in that instant, it wasn’t about sickness at all. It was about a family being a family, irrespective of the circumstance and I was glad to have shared in that.
