Sometimes I Pretend They Are My Father

My patient was a reconsult in the ICU. This was a patient my colleagues had seen the prior week. They had provided input and then signed off (left his care to the Intensivist). He had a complex combination of health problems including heart failure. The ICU team called us to come back and provide further input. 

There was not a lot for me to add. I dutifully reviewed his chart and his imaging studies in depth. I then went in to talk with and examine him. He was in his 80s. He had recently suffered a stroke. His speech was slow. He was not completely oriented, but he still tried to maintain his dignity and his identity. His wife and daughter were there and were almost too attentive. They anxiously participated in my history and exam of the patient. They seemed to hang on my every word. I didn’t have a lot to add to his care. I thought of making a quick exit from the room and moving on with my day.

And then I didn’t. 

Something happened that changed the whole scene and honestly changed my whole day.  

I looked again at my patient, and then at his wife and daughter, and the whole scene in the room. It made me think of my Dad. In that instant, I thought about my father, his times of illness and his times in the hospital. How would it change how I viewed things if the man in the bed were my father? In order to understand I decided to (in a sense) pretend he was my father.  Not fully pretend – but just enough to look at him and try to picture my patient like I would have looked if it were my Dad in the hospital bed. 

This changed things A LOT.  Suddenly there was more to the man who was in front of me in the hospital bed. I could see beyond. I could imagine what he was like before age and illness had changed him. I looked into his eyes and then turned to look at how his wife and daughter looked at him. It was then that I truly could understand. They didn’t see an elderly frail, weak man with so many medical problems. In their eyes I saw reflected a younger, stronger man. I saw someone who worked hard. I saw a solid secure person who was the one that they leaned and relied on.

As a child, I remember being amazed at my Dad. He could do or handle anything. I would struggle to lift the bushel crates of apples (about 50 pounds).  My Dad could stack two bushel crates together and then lift both of them over his head. He would do this so that he could stack them in the cold storage higher than any of the rest of us.

My mind drifted to more memories of my Dad. I thought of him navigating the small little forklift around moving boxes of apples in tight areas. He had to wrap a pull rope on the engine to get it started. If it wouldn’t start, he could fix it. He was confident. He could fix anything or do anything that he needed to do. If it needed to be done, he would just do it. I remembered listening to him talk with my grandfather. Together they would work through complex decisions about running the farm. 

I thought of him as a high school teacher. He was always calm and always in control. He never seemed to get flustered. He loved to laugh and would get a twinkle in his eye at times. He was a solid reliable figure in the school. Everyone loved and respected him.

My Dad passed away last November. His cancer had aged and weakened him before he died. But when I think of him, I don’t remember that stuff. Instead, I remember him as the strong and robust man who could do anything. 

I looked once again into the eyes of my patient’s wife and daughter. The scene was so different than what I initially saw when I first walked into the room. Their facial expressions, their attentiveness, and their questions now all made sense. They could see so much more than what was obvious. I looked back at my patient, and I slowed down. There was indeed so much more there. I suddenly didn’t want to leave the room. My long list of patients and work yet to do didn’t matter as much. We talked more. As we did, I learned more about him. He was truly frail and not able to tell me much, but he didn’t need to. The four of us could now somehow together see a much more full and complex understanding of who he was. 

When I left his room, I was honored that I was allowed to be a part of his medical care. I felt better. I’m not exactly sure why. I think part of it was a feeling that what I was doing was important. I had purpose. The person I was taking care of was important. 

I decided that it was good what I did in my mind that day. I resolved that I should do it more. Who is the person beyond the hospital and before the illness? What is their world like? What was their world before?  

Since that day I have continued my game. I refuse to just see who they are in the hospital bed. Instead, I pretend they are people who have been important to me. Let me be clear. I don’t assume that they are the same as my family or friend that I remember. But if they were, how would I want a doctor to see them, to talk to them, and to care for them? In this thinking of the depth and complexity of my family or friend, I am able to push myself to see more.  

Today I was consulted on an 89-year-old with heart failure. She was hunched over and asleep when I went into the room. I woke her to talk with her and examine her. She was small and frail. She had a prominent kyphotic (bent over) deformity of her spine. She was confused. She didn’t provide a lot of information to me. 

I paused a minute. I imagined my grandmother. My grandmother was a strong farm woman in her day. I thought of all that she was and meant to me and my family. I stopped. I pretended that this patient was my grandmother. This changed the entire scene for me. Suddenly there was a lot more going on. My patient was complex with a long life and lots of details to her past. It would be amazing if I could somehow learn more of who she was. I was determined to do the best that I could to help her just like I would have wanted others to do for my grandmother.

And so, sometimes I pretend they are my father.