Wednesday, January 09, 2008


I knocked on the door as I entered Patient H's room. His wife and grown children were sitting on the couch. Patient H put down the papers he was reading and took off his reading glasses. They all turned to look at me.

I let out a quiet sigh and began.

Me: I've got bad news...

Once a person enters a hospital as a patient, they're stripped of their familiar comforts and placed in a sterile and unfeeling environment. The only constant from their home life remains their illness, which the doctors are also working hard to remove. Much like joining the military, all forms of individuality are removed and soon every patient takes on a sterile anonymity, differentiated from others only by their name on their wristband.

All that they had known before is now unknown. Their familiar routine is disrupted. Suddenly nothing is predictable and everything is uncertain. Their prognosis, the unfamiliar medical words, the neverending stream of unfamiliar faces coming to poke and prod, asking the same questions...

The patient is no longer in control of their lives. Their future now lies in the results of "tests" and "studies", to which there is nothing they can do to influence the outcome. Overwhelmed by the circumstances, the loss of self, the dizzying medical jargon, and the frustration that comes with not understanding their disease or the complex process of diagnosis and treatment, comes the sense of helplessness and apprehension.

In rare circumstances where a choice of treatment may exist, patients are given the opportunity to choose a treatment modality. But this isn't as simple as choosing between the creme brulee or the cheesecake. With little understanding of their medical condition or the ability to fully comprehend the impending consequences of the different treatments, most patients relinquish their control of their medical treatment back over to the physician for fear of further exacerbating their condition, giving up what last bit of control they had of their lives.

When a patient is removed from having full control of their lives to none, sometimes in a matter of hours or days, fear and frustration builds. And patients will often transfer this energy by lashing out at family members, nurses, or physicians.

And so was the case with Patient H. Who, when told that his cancer had spread and was inoperable, raged that I simply had no interest in helping him because of his race. He attacked my training. He attacked my intellect. He attacked my motivations, my age, and my inexperience.

And with each outburst, I stood there at the foot of his bed silent, biting my tongue, and just took the hits as they came. Who's to say I'd act any better if someone delivered a death sentence unto me?

His family came to his side to console him, and after answering all of their questions, I excused myself from the room. Although I can rationalize and understand the reasoning behind this unwelcomed animosity, it still didn't make it any easier to tolerate.

Being accused of not doing my best to care for somebody... That definitely hurt the most.