The hidden patient

Originally published in The Medical Post, VOLUME 36, NO. 27, August 8, 2000

In June, my dad was hospitalized for some surgery. He related the following story to me: My dad walked the ward after his surgery whence he came upon an elderly woman near the nurse’s station.

She appeared frail and had several scars upon her scalp suggestive of old cranial surgery. Tied to her wheelchair by a drape of bed sheeting, he noticed that her right hand was moving.

At first he thought these hand movements were involuntary, and yet something did not seem right. He asked the nurses about her but was told that she was demented and was not aware of her surroundings.

During this brief conversation he noticed that her hand twitching was more deliberate. Not a man to accept incongruous answers to observations that demanded a better explanation, he did what any man of science would do, he tested his hypothesis. He approached her and took hold of her hand. He instructed her that if she understood his questions to squeeze his hand once for “no” and twice for “yes.”

“Do you understand what I have said?” Two squeezes.

“Can you hear me?” Two squeezes.

“Do you like your doctor?” One squeeze.

“Do you want to sue your doctor?” Two squeezes. (My dad is also a joker.)

He saw her eyes light up after this brief contact. He returned to the nurse’s station and demanded her doctor be called to the floor at once.

After a short spat of curt banter the nurse acquiesced and the doctor did indeed present himself. My dad related his observations to the doctor.

The doctor was skeptical and responded that she indeed was demented. My dad asked him to take her hand and to repeat what he had done but asking her different questions.

Again, she responded coherently to each question. My dad noticed that the doctor went pale and had a look of horror upon his face. He immediately transferred her to the rehabilitation unit.

My father felt on top of the world after that incident. He saved a woman from a life of hell; locked inside her body yet fully cognizant of her surroundings and with no one hearing her scream for help.

We, as physicians, can sometimes assume too much.

We have all committed this error to varying degrees during our careers. I think we all need a good reminder every so often about how we can affect someone’s life for good or for bad.

At times we can be so overwhelmed by our workloads and responsibilities that our empathy suffers.

Trying to provide so much to so many in so little time in our rush to keep up, we lose a part of ourselves that made us become doctors in the first place. At times we base decisions upon preconceptions.

My father experienced such joy that it brought him to tears. All of us should keep that feeling close to our hearts.

We cannot cure everyone but we can still make a difference to people if we take the time to listen. My father’s simple act of taking someone’s hand changed their life.

My father is not a scientist. He has never taken a science course. He sold insurance, drove a taxi, owned a grocery store and is an excellent butcher.

He has had to communicate well in all his endeavors. He notices people. We ask ourselves and are asked at times where we learn to be a good doctor.

I can proudly say I am my father’s son.

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