Nicholas Panting

On November 12, 2016, my father went to the ER at a local community hospital because he was very tired and he had difficulty speaking. The family was concerned that he might have suffered a stroke so the medical staff performed a series of tests to determine the cause of his illness. A CT scan was performed and the staff physician had to return and inform my father that he knew what was causing his speech impairment and that it was not due to a stroke. The results came back showing a tumor in his left temporal lobe, in his speech areas. My parents were shocked to hear this news and they immediately proceeded to call various family members. I was in Grenada finishing up my 4th term of medical school. I remember getting the call from my mother saying that there was a mass and the feeling I had was indescribable. I instantly went into the stoic medical professional persona and reassured my mother and father that the mass was most likely benign and would be removed with ease, when in fact; I had no clue and was worried with the rest of them. It was the first time that I could recall fear and I instantly prayed that my father would be okay.

My father was directed to a neurosurgeon to remove the mass and his surgery took place on November 15, 2016. Maybe it was fortuitous, or maybe it was plain irony, that my classmates and I were starting to review neuropathology. When the surgeon came out to the waiting area and described the tumor to my parents while I was FaceTiming, I instantly knew that this mass was not benign. Nobody in my family is a medical professional, so the words coming out of the surgeons' mouth could have been a foreign language. After he left, they instantly asked me to play the role of translator. I was honest with my family, especially my mother, and told her what I knew and what the textbook describes but reiterated the surgeons' words were what we needed to wait for, and the pathology report, for final diagnosis.

Two weeks later, we received the news. My father was diagnosed with Grade IV Glioblastoma Multiforme. This is an aggressive tumor that normally carries a prognosis of 10-12 months. The feelings of fear came flooding back and I experienced a surreal feeling. I was in a unique situation where I was immensely feeling the emotions of a family member while also trying to be a reserved and emotionless medical professional.

When I went home for Christmas break, I spent time with my father and took him to his doctor appointments and met with his medical team. The physicians eagerly brought me up to speed, which was reassuring. However, I noticed that the rest of my extended family members seemed to reiterate their questions repeatedly. This told me that the medical team was unable to effectively explain the course of the disease to my family as well as to dispel their fears and concerns. My first impression of my father's physicians was that they were clearly competent and suited for the task at hand but I quickly noticed the burden of their job in the form of the sheer number of cancer patients that they see every day. His physicians were only able to spend a certain amount of scheduled time with my father in order to serve all of the other patients. This restraint, in my opinion, left them inept to address the little things that were concerning to the patients. I understood the situation that the physician faced but I could not help but feel helpless because it was the little changes in my father's daily routine that he noticed and that which greatly affected his confidence and mood.

I decided to continue my observations and learn from the interactions of my father's physicians. I saw first hand how important it was to the patient to feel they were being heard by the medical team rather than being seen as just another case to be approached in textbook fashion. I saw that there was value in taking an extra few minutes to ask the patient their thoughts and feelings on things. I found additional value in asking the physicians what they could do to improve the patient's experience and overall morale.

This knowledge and awareness came to fruition in early February when, at Grenada General Hospital, I encountered a patient who was in the Internal Medicine ward with a diagnosed case of cellulitis. My attending physician asked me to perform a head-to-toe examination encompass every system. The patient was in pain and her main concern was her leg and that I not aggravate the pain there. I listened to the patient. I reassured her that I would not cause her any undue pain or stress and that if, at any time, she was uncomfortable, we could stop the physical examination. I took my time and asked questions as I went, making sure to fully explain myself to her so that she felt comfortable and a part of the process.

Finally, I arrived at her lower limbs and once again reassured her that I would not cause her pain. I simply laid the back of my hand on her leg and I could feel the warmth of her infection. I could see the physical appearance of her skin and I could see how she was favoring it.

After the physical examination was complete, I graciously thanked her for allowing me the opportunity to examine her and for the opportunity to utilize my newfound empathy and understanding.

By keeping what I had learned through my personal experiences with my father and his medical team in the back of my mind, I had enhanced my skills as a student doctor by applying that knowledge to the care I provided to my patients.