by Andre Savadjian
It is often said that medical professionals should connect with their patients on a deep level to help forge a better rapport. As students, we are taught early on in medical school to establish caring and empathetic relationships with all of their patients. Sometimes, that can be found during those few private moments; facial expressions convey volumes and a patient's glance may oftentimes be their only means of communication. Medical settings such as the ICU provide a unique environment where physician-patient relationships can be very substantial.
She is awake, lying in bed, with a breathing tube down her throat. From afar, I can tell she is agitated, be it from the constant foot traffic of the nurses, doctors, and respiratory technicians, or the incessant bells and alarms from the breathing machine keeping her alive. Her two daughters at her side have had minimal luck calming her down. Early on my rounds this Monday morning, I walk into her room, smile, and say "hello."
She looks up at me and grins ear to ear with large, glowing eyes. She grabs my hand firmly and musters up the strength to mouth back a simple "hello." I introduce myself as part of her medical team and explain what is to be expected in the coming days in terms of her aggressive medical treatment. She nods in understanding.
Throughout that week she is frequently distressed by the nurses and technicians' care, as they must routinely turn her, clean her, and suction her breathing tube. The next time I appear at her bedside, she beams again, holds my hand close to her body, and finally relaxes, allowing those in her room to do their job. Before all the vital procedures she would receive this week, including ones where she will be sedated, she points to the hallway, and silently, but sternly makes it known that she wants to see me in the room before beginning.
This gravely ill woman, unable to breathe on her own, is now requiring almost total support from the breathing machine. On the last day of my rotation in the ICU, I walk into her room and see the same smile and my hand is held by the same strong grasp. I regrettably explain to her that I will no longer be a part of the medical team starting tomorrow. Her radiant smile starts to fade as she begins to cry and clutches my hand even tighter as bells and alarms begin to ring out from the machines, echoing the pain from inside.
Her two daughters tell me how much they appreciate me, and that their mother loves seeing my smile every morning. With a glimmer of hope that I could stay, they say that no one has lifted her up like this in years.
It is only upon looking back on my time in the ICU that I realize the truly special nature of this bond. In the moment, my commitment to my role as a medical professional made me become unaware of the power of my own smile, which was the basic component of this physician-patient relationship.
Author's Note: "I have been attending the SGU Atlantic Health Humanities sessions since the beginning of my 3rd year in Fall 2016. There have been numerous exercises involving writing and I have come to appreciate its purpose in medicine. This selection is is intended to serve as an example of how writing in medicine can give more insight into the physician/patient relationship."