Saturday, February 14, 2015

Beyond chocolates and buy-one-get-one-free roses.

"And as the sun starts to rise today, Valentine's Day, 
I know I've just seen what true love looks like."

~ Joelle Rosser, MD

I woke up to the sound of Harry rhythmically breathing. As soon as I stepped out of my bedroom door, I heard more familiar sounds. Zachary was sitting criss-cross applesauce on a bean bag playing Madden Football on the Playstation 4. Isaiah was in the sunroom lounging under a big, fleece blanket, not so much because it was cold but more because blankets just feel good sometimes.

I picked up a sock off of the floor and began making coffee. I opened the fridge and then reopened it again to determine the unpleasant scent that had just wafted out. It was the chicken stew from last week--Ewww. With coffee in hand, I gathered Zachary's uniform for his basketball game and then sat down to check emails for a moment.

One of the first things I see is one with this in the subject line:

"Musings from the hospital on Valentine's Day morning."

Oh snap. I'd actually forgotten all about today being dia de San Valentin until that very moment. In my own defense, we did have an early Valentine's Day dinner as a family at my favorite restaurant on Thursday. I guess that made today feel like a "regular old Saturday" -- which mostly it seemed to be turning out to be.

But then I read that email. It was from one of my former students, Joelle, who is now in her internship on the other side of the country. She'd typed her stream of consciousness into an email after a pivotal evening caring for human beings. And I froze in my tracks after reading her words.

I just want you guys to know that the future is in good hands. The young doctors coming up have hearts the size of Texas and are not in it for the money or the social position. Her words also made me smile thinking, "You can take the doctor out of Grady but never the Grady out of the doctor." Never.

Joelle was kind enough to allow me to share her words here today. I can think of no better way for this Grady doctor to honor this day that is supposed to be about love than to post these reflections on its true meaning. Love, that is.

Thanks, Joelle.


Reflections of an intern on Valentine's Day morning

It's 4AM. I'm working the night shift for the oncology service. I've taken care of everything for my new admissions and most of the other patient's I'm covering for are sleeping without any active issues. I have a few minutes to breathe. To check in on a few patients. To think about what it is that I'm a part of tonight. I visited Mr H.

Last night I spent most of the night watching his blood pressure teetering on the edge of requiring a transfer to the intensive care unit. He has metastatic colon cancer. His blood has less than half of the normal amount of albumin (a protein that helps keep water in your blood vessels instead of leaking into your tissues). I gave him fluids. His blood pressure would go up for awhile but then the fluid would go into his tissues and his blood pressure would fall again. His legs were swollen up to his belly from all this fluid. The next step is giving medications to increase the blood pressure but this requires putting in special IV's and monitoring devices and an ICU. The labs were telling he that his body was not too happy with his current blood pressure. He was telling me that he was not too happy about going to the ICU. We waited. He hung in there. But I spent the night watching his numbers - his vital signs, his labs, his urine output.

Tonight I watched something else. I watched his family sitting around his bed. His wife and his daughter each holding a hand. The room was dark. There was gentle music playing in the background. I watched over the course of the night as we tried to get his pain under control, as he went from sitting in obvious agony to dozing off. I looked on as a man died. A husband. A father. I saw a room filled with love. And my heart broke. Bearing witness to a family saying good-bye for the last time.

There's no looking at numbers tonight. This is the part of medicine you aren't taught in books or lectures. It's the part that hurts. But it's also the heart of medicine. In between responding to pages and writing orders, I was reminded that I signed up to care for people when they are sick, hurting, and sometimes even dying. It's not a job. It's an incredible privilage to be a part of these moments.

And as the sun starts to rise today, Valentine's Day, I know I've just seen what true love looks like. It's not red and pink. It doesn't smell like roses or taste like chocolate. It's not bold or flashy. It's neither lustful nor selfish. It doesn't need. It just gives. It smells like home and tastes like tears. It feels like the warm sunshine. It's quiet. It's resilient. It's for keeps. Even after that last good-bye.

~ Joelle Rosser, MD, Post Graduate Year 1

I am so, so proud to have been on the other side of "send" after she honored her patient through that early morning email. What is being a great doctor about? Without question--love is the what.

Always, always, always.

Happy Valentine's Day.


  1. Thanks be for all the Joelles, and you.

  2. Unrelated - maybe this sîbnger will earn her place on your mental i-pod (I shamelessly stole that concept, thank you!):
    love from Switzerland

  3. I believe it is a privilege to care for the dying as well.


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