Oh no, I said too much.

"Every whisper. . .
Of every waking hour I'm
Choosing my confessions
Trying to keep an eye on you
Like a hurt lost and blinded fool, fool

Oh no, I've said too much. . ."

~ from R.E.M. "Losing My Religion"

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Sometimes patients ask you things that catch you off guard. Things like, "Hey, what race are you?" or even funny ones like, "When's the baby comin'?" when you aren't even pregnant. And sure. Those questions can be both perplexing and amusing at times -- which reminds me-- why is it that only black folks ask (black) me "what are you?" or even why is it that the very day you feel your most sleek and trim post-pregnancy just happens to be the day that some patient winks at you in the elevator and says, "Is it a boy?"

Um, yeah.

But those questions? Those questions are easy. Here's a question that can be a hard one:

"Do you believe in God?"

Or more specifically if you work at a place like Grady Hospital:

"Do you believe in Jesus?"
Now here's the thing: even for folks that have a very clear answer in their head to that question, it isn't necessarily an easy one. It steps into a fuzzy place that sometimes doctors get squirmy in with their patients. That personal space place. That inner thoughts and feelings place. And for some, that flat out none-of-your-business place.

Hmmm.

Today I'm reflecting on this because yesterday I was leading a session with my second year small group students and the topic was "Spirituality and Medicine." Our discussion started off simple enough and then evolved to this one where we got into a very interesting dialogue about how one responds to patients asking questions about your religious beliefs (or lack thereof.)

The students had some interesting perspectives. They represent many different beliefs on a myriad of intensities, so I was keen on hearing their thoughts. One person asked if the best thing to do was to "just tell the person what they want to hear." Another was firmly against that. Some offered thoughtful examples of how they could navigate respecting where the patient was and protecting their own privacy. A few weren't sure what they'd do. And eventually, they asked me what I thought.

members of "Small Group Beta"

Okay. So, I think I am fairly transparent on this blog, or at least I try to be. Most have probably gathered that I am of Christian faith and wouldn't be surprised when I describe myself as observant. Nope, I'm not fire and brimstone. Nope, I don't have flaming stones to sling from my purse or hateful, disgusted stares for boys who hold hands with boys. Nope. I generally stay in my lane when it comes to judging since the whole judging thing is not my lane. I tend to focus more on that whole "love everybody" thing that Jesus was so into.

Anyways.

I don't pretend to be anyone other than who I just described and have what I like to refer to as a "personal relationship" with God. I pray regularly. Some days more than others. And fortunately, since my relationship with God is personal and we know each other so well, my guess is that He's cool with that. Some people fall into this "personal relationship" category, too, but their relationship with a higher power is so personal that chatting them up about it is like asking them about their weight. A major no no.

Though that isn't usually where I am, I do sometimes wince a teeny bit when the topic comes up. Sometimes it's because I am accompanied by someone else. Other times it's because I fear it will take me somewhere I am not sure I want to go with a patient. So, to answer their question, I tell them something that I heard a resident once say on rounds when asked those very questions:

"May I ask a question of you? Can you tell me why it is that you'd be interested in knowing that about me?"

It was one of the most kind replies to such a question that I'd ever heard. This came out of the mouth of a second year resident, too. He softened his eyes and his voice and respectfully countered with this beautiful response. And I meant to say "beautiful" because it was just that.

This resident happened to not be of Christian faith at all. But the answer the patient gave was so endearing. She simply said, "I want to know because I really like you. I want to know that your soul is saved, so that I can be praying for you if it's not."

And he replied, "I always appreciate prayers."

And she simply smiled back and nodded.
I have used a version of this ever since. One patient answered me by saying, "I want to make sure that the doctors caring for me are believers and that they don't think they God!"

I was with my entire ward team that day, and through this insight was able to answer accordingly.

"Ma'am, to be honest, I am of Christian faith. But more important, I certainly do not think that I am God. I also work with a number of wonderful doctors and students--some of whom are of Christian faith and some of whom are not--and I feel sure that they don't think of themselves as God or all powerful either. We just try our best to do right by you and give you our very best effort. That's something you should want all of your doctors to have in common."

And that answer feels good to me because it doesn't exclude or disrespect the scores of colleagues I have that have different beliefs than my own. Particularly when they are present when I'm asked.
Now. I'd be dishonest if I told you that there hadn't been many a time that I'd joined a patient in prayer or agreed to pray for them. In fact, I've closed my eyes and prayed for a patient right then and there at their bedside before. This has depended upon a lot of factors. The relationship I had with the patient, the urgency of the situation, and of course, the wishes of the patient. Other times, those prayers have been uttered quietly at chart boxes or in stairwells. . . oft times the nearest place I can privately reach to interlace my own beliefs with what I can do medically.

I am not sure these answers are the right answers. In fact, somebody reading this is probably saying that they aren't even close to the right answers. I don't know. But here's what I do know: Medicine is about a whole lot more than medicine. And regardless of what you believe or don't believe. . .it involves having some faith. Sometimes in you. Sometimes in your doctors. And sometimes, if that's your thing, in something altogether different.
***
Anyways. That's all I've got today. Happy Wednesday.

Now playing on my mental iPod. . . . .



Losing my religion by REM

Beyond belief.

image credit

"One day I'll fly away

Leave your love to yesterday

What more can your love do for me?

When will love be through with me?

Why live life from dream to dream. . .

. . and dread the day that dreaming ends?"

~ "One Day I'll Fly Away"
lyrics by Will Jennings, music by Joe Sample

(now hearing this version on my mental iPod)

____________________________________________________________

My rounds were quiet and peaceful that day. The interns had the day off, and the resident was putting out fires on other floors. This time for you would not be divided by medical student queries or carefully guided tours of your physical findings (with your permission of course.) I was all yours that day.

It was a weekend day, so there weren't even any meetings to race over to be late to or conference calls to dial into or students shuffling their feet in front of my office door or urgent emails to return. The kids were somewhere climbing jungle gyms or splashing in puddles or licking syrup off of their hands with their dad who had kindly sent a text that simply said, "We're fine." So that meant that, on this day, I was all yours.

This day, I saw you in morning light so bright that it made me take pause. Despite the overcast sky and its imminent plans to deliver a torrential downpour, somehow the rays that were stubborn enough to come out any way managed to find you. Your hands were idle, folded over your abdomen; your eyes tired and fearful. It had been a rough night; the pain had been at almost a 'ten' until finally you told someone and ultimately received a higher dose of pain medication.

"I hate to be a bother," you tell me.

"But you aren't a bother," I quickly reply. "If you are in pain, I have failed you."

"Okay." Your face washes over with a blanket of childlike comfort, but not your eyes. I can still see fear. Cancer is something to be afraid of. Especially this one.

I glance over at the window sill. Not a single card or flower. No photos of you posing with loved ones during the honeymoon that preceded this diagnosis and no worried significant other abruptly rising from the bedside chair upon my approach to examine you. It was just you. And today, just me.

"Are you? In pain, I mean?"

"No. I am okay."

"Good."

I carefully pull back your cover and examine your cachectic body. My stethoscope rocking over your ribs; their perfect outlines like some kind of skeletal relief sculpture. Your lungs sound surprisingly clear on this day, and outside of the mild tenderness around your feeding tube, your sunken abdomen is equally unremarkable. I inspect your legs for any asymmetry; your backside for redness from the pressure of lying in bed more than standing up and making it.


No, your exam is not normal. But for this day, it looks pretty close. With the exception of your fearful eyes, it is normal enough to plan your discharge.

"There is so much to coordinate," I say softly. "Our plan will be to get all of this done for you and discharge you first thing in the morning. How does that sound?"

"That sounds good."

"What questions do you have for me?"

Your smile is warm and genuine. Your bony cheeks and wasted temples perfectly framing your every expression. "I think you answered them all."

I reach down and put my hand on your soft cheek. "Are you sure? Is there anything you need?"

You smile again and shake your head. "I'm okay."

"Okay."

I step back from the bed and delicately arrange the covers over your tiny shoulders. I fluff the pillow and tuck another blanket around your neck; enveloping you in as much safety as I can.

"I'll see you later, okay?" I say after finishing my fuss over the bed.

You nod and smile once more.

I walk away from your bed and that morning light. . . . around the thick pink curtain dividing it from the other side of the room where the neighboring bed was empty. Suddenly, I abruptly stop in my tracks. The next thought I continue to replay because it was so memorable. It was simple and clear--like the single chime of a tiny bell--and enough to halt me in place:

Maybe I should go and just sit with you. And hold your hand and maybe even. . . . pray with you. Or better yet just be with you a little longer.

The Grady elders might call this "The Lord puttin' something on your heart." And they call listening to such a thing "being obedient." Others might call it something else or even be uncomfortable thinking about it. Regardless of what you call it, it was something. Something strong yet fleeting that I somehow allowed to come and then go in the blink of an eye.

I lean back around the curtain and into your light again.

"Ma'am?"

You raise eyebrows and turn in my direction.

"Umm. . . you. . . make sure you remember what I said about the pain medicine, okay?"

"I will," you murmur quietly. "I will."

And with that. . . . I leave. Thinking I can do it tomorrow. Letting go of that moment in time on my solitary rounds.


Early the next morning, the intern covering the team on call left a message on my voicemail. You were found pulseless. They worked on you as hard as they could to bring you back. But unfortunately, they could not.

No! I must be hearing wrong!

I remembered your pleading eyes and those words put on my heart. I replayed the message and immediately felt my pulse quickening and my eyes welling.

No! It wasn't time yet!

But actually, it was. That morning, I stood listless in a hot shower crying and crying. Not because I could have saved you. And not because I could have cured you, either. But because I didn't listen. And regardless of what you believe or who you pray or don't pray to, sometimes you get a little nudge that tries to give you a message. This time, your eyes tried to tell me. And even after your eyes tried, something else tried, too. But I missed my cue.

Now I know. That day, I was supposed to be the cards on your window sill and the flowers on your tray. And even though you weren't in pain, in a way I did fail you. I should have yielded to that tug, that magnetic force that was pulling me back to you. And I'm sorry. I'm so, so sorry I didn't.

But.

Today, I will dry my eyes and honor you. And for you, I will never ignore that whisper laid upon my heart again. Because that time was your time. And on that day it was just you and just me. So next time, for you, I will be obedient.

***