Have you cried while talking to a patient?
I Almost Did!
Ask yourself: Is it okay to cry with a patient?
It was a chill morning when I decided to speak to a patient and gather a full history. Everything was fine, the history taking was going smoothly, given that the patient was currently going through a difficult time in terms of their health as they were soon bound to be disabled.
One of the things we have to ask about in history taking, ESPECIALLY when disability is part of the conversation is to do with social support. I.e who does the patient have to support them at home. Someone to take care of them, someone to cook for them, someone to help them shower, wash up after the toilet etc.
When asking this patient about that, they mention that their children will be coming to help them out until they get professional help. When asking what their marital status is and if they have someone else at home, the patient went on to talk about their deceased spouse.
The patient mentioned that they lost their spouse 3 years ago. Usually, we are taught how to handle these situations in medical school. It sounds robotic, but you have to add your own flair to it, or your own personality to make it less robotic. Usually, we respond with
I’m very sorry to hear that you lost your spouse, it must have been a difficult time for you.
or
I’m very sorry that you had to go through that, how did you and how are you coping?
Then we listen to the patient, make sure all is okay with them and move on. However, with this particular patient, it was a bit difficult for me to ignore the emotions going on. Was it maybe because I had already built a very good rapport with this patient and I felt slightly closer to them? Was it because I had already developed feelings of “sorriness” or “pity” because of this patient’s current disability-related scenario? I’ll never know..
The patient went on to say
My spouse had alzheimers and can you imagine the feeling of when someone you have been married to for 50 years suddenly no longer recognises you?
That feeling when you are trying to help the person you love to get dressed, however, they are screaming because they do not recognise you and think you are trying to harm them
When the patient said this, I could feel the tears forming and my throat starting to choke up. All I could think was “ do not cry in front of the patient, do not cry” whilst also thinking about how much this patient had gone through.
Me trying not to cry:
Me inside:
Giving the patient a reason to be happy
Towards the end, the patient mentioned that their spouse died in their arms and they mentioned that the spouse looked at them and smiled before shortly passing away. (Throw me a Goddamn bone am I right?).
This was a first-time situation for me. I had never been in a situation like this and I thought I would say something to make the patient feel better, and therefore I said
It is as if she smiled because she recognised you during her last few breaths
This caused the patient to smile a little
Question is, did I lie? I’ll never know
Did I say the truth? I’ll never know
Did the patient need to hear that? Yes. I would’ve liked to if I was in their shoes.
All I was trying to do was tell the patient what the spouse COULD have been thinking at that moment - and that is enough for this patient to take that to heart and enjoy the thought that the woman he loved and was married to for 50 years, after a period of no longer recognising him, in the end, recognised him.
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My name is Habib and I am a 5th-year Medical student currently in Cyprus. I grew up in Tanzania (Hakuna Matata is from the local language of my country and the second tallest mountain (Kilimanjaro) is found there).
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This was so touching! I think being emotionally distant whilst displaying empathy is definitely one of the things i will struggle with in clinical years