Bruce Campbell MD
Beneath the Surface
Could a greater miracle take place than for us to look through each other’s eyes for an instant?
-Henry David Thoreau
It is almost 7:00 a.m. and I carry my backpack and lunch bag from the car to the office. I nod to some of the night shift employees heading home. Another day has begun.
I check the computer, reminding myself of the twenty patients I am scheduled to see today in the cancer clinic. A few new consults with untreated or recurrent cancers occupy the longer appointment slots. Follow-up and post-operative patients will be seen more quickly. It will be a full day but, hopefully, I will grab a few minutes around noon to eat my sandwich.
I print out some office notes and carry them to our weekly Tumor Conference. Several physicians present cases for discussion. We review the scans and the pathology, making recommendations for treatment. We determine who is eligible for clinical trials. We look at recent research results. Usually, a brief discussion will mean better news for the patient; we have something to offer. Extended discussions usually reflect a lack of good options.
Clinic gets going. First is a 64-year-old man with a tongue cancer. His symptoms have been present for about six months. The scans are helpful. The cancer has not caused much damage. Only one lymph node is involved. Everything else looks fine. I run through the surgical risks, benefits, and alternatives. I prepare the consent form and look at the schedule. Any questions?
He drops his head, hands gripping his knees. “My wife would have known what to ask,” he tells me. “She died six weeks ago. That’s why I waited so long to come in. I was caring for her.”
I pause. There is a story pressing in on us from all sides. It floods the room.
“I am so sorry,” I reply. “I am glad you are here. Your cancer is still very curable. Tell me about her.”
We spend some time. I am soon behind on my schedule. There will be more stories that need to be shared before the day is through.
A YouTube video from the Cleveland Clinic is a spot-on rendering of what happens every day in a hospital. See what you think. No matter where we are, stories surround us, but they are closest to the surface when we are most vulnerable. Recognizing this reality should be part of the repertoire of every physician. We teach this to our students and residents. Even still, how easily we all forget!
It is 6:30 p.m. when I carry my backpack to the car. I will work on my Epic notes this evening, or maybe not. Tomorrow will be here soon enough.