REFLECT

Model stories written by young professionals/students.

 

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Breaking Bad (News)

 

 

My biggest concern going into the field of medicine is that I will get too attached to my patients. This could have a trickle effect into more serious effects, as I would have a hard time breaking bad news or seeing a progression of a worsening illness. I know that this could potentially cloud my vision as a physician making decisions regarding patient health. In my shadowing experience this week I have seen exactly how these situations should be handled, and am very thankful to have an inside look on how to perfectly deliver news that no one and their family would want to hear.

The morning began rounding yet again and visiting patients in the stroke Intensive Care Unit. We visited several incredibly sick patients, ranging in degree of stroke and the lasting effects that it had. I stumbled in and out of various patients’ room, following closely behind the neurologist I was shadowing. We had just left a room where a man had suffered a massive stroke to the right side of the brain, which had affected his whole left side. He was still having movement in his arm, which the doctor was thrilled about, but his left leg was not looking as promising. Suffering from severe aphasia as well, the man was practically incoherent, although he recognized that the doctor was in the room. The man had no family or friends at his bedside, which I found devastating. He was essentially clueless to his condition, and it quite frankly broke my heart. I was so worried about this man, as I immediately put myself in his shoes, and wondered where on earth his loved ones were. My shadow was not shaken nor stirred, and proceeded with a genuine kindness toward the man, nurses, and staff. I was already a little taken aback by this first patient, and had no idea what I was getting myself into.

I followed the doctor into the next patient’s room. She was an older woman, and was sitting in an arm chair next to her daughter and son-in-law. I immediately watched the doctor’s heart warming welcome to check on the patient. Once he had performed his series of exercises, which I later learned tested how the brain was able to piece information back together, I felt his demeanor change, and I knew the bad news was coming. After checking the woman’s name, I had remembered reviewing her chart previously that morning. She was continuously suffering from strokes, and after an already hard year that consisted of moving to and from the ICU, thethe family was clearly very stressed. I knew this, and so did the physician, so he took a seat next to the woman’s daughter, and began to explain the situation. I stood there listening attentively, trying to understand the case fully. The daughter immediately began crying as he explained the continuation of strokes and the severity of the woman’s condition. The patient herself was glazed over, and I could not tell if she comprehended the situation or not. However, the doctor was fully addressing the daughter and her husband. As an understatement, I was in awe of his bedside manner, and ability to make even the worst of news seem okay. You could tell in his gesticulations, eye contact, and diction, that he was serious about her treatment, and was genuinely concerned about the patient and her family. I was so impressed with how he delivered the case, but said that they were going to aggressively assess treatment options. Once he had said this, both the daughter and the husband perked up, as they realized that there was still hope.

Leaving the ICU that day, my thoughts were jumbled as I was recounting the events. It had been a crazy morning. I could not stop thinking about the man who was suffering alone, and the lady who was lucky enough to have a great family at her side. Then I began to think of how the doctor had handled both of these cases with such grace and empathy. He was everything you could hope to be in a physician delivering the worst of news to patients and their families, and I considered myself incredibly lucky to see this in practice.

I left the hospital that day a little settled in my fears that I would be too attached to patients and their families. Although it is incredibly difficult being the bearer of bad news, I also believe that this was something that he had mastered as time went on. The physician was not only the expert on behavioral neurobiology and Alzheimer’s Disease, but also on how to be the bad guy. Although I know this takes practice and training, seeing it in practice only alleviated my worries, because it seemed as though this delivery of news only brought him closer to both the patients and their families.

-Kennedy Karem