I haven’t thought about her for 47 years; it’s been a while. I know that it’s been 47 years because I was a first-year medical student in 1976. We were seated in the auditorium listening to Prof. Hebbel Hoff give a lecture. He taught physiology as well as an elective on the history of medicine. During any random lecture, he would expose us to a bit of philosophy as well. This particular afternoon, he showed us the image of H. Legging’s 19th Century painting, The Sick Bed.
The painting shows a woman lying on a cot. Beside her is a wooden trunk serving as a night stand with a bible, a glass of water, a spoon and perhaps some medicine. Her doctor sits in a chair beside her cot holding her hand. To me, she looks pale and thin; I suspect tuberculosis, but who knows?
Dr. Hoff showed us this picture to emphasize the humanistic aspect of medicine. The doctor in the painting is attending his patient for whom he has no medicine but the compassion in his heart and the touch of his hand. I don’t remember Dr. Hoff’s words, but I do recall their meaning.
There will times when there is neither medicine nor technological wonder to alleviate the suffering of your patient, but there will always be the comfort of your touch and presence.
I haven’t thought about her for 39+ years; it’s been a while. I know that it’s been that long because I was in my residency. I was seated at the nurses’ station reviewing the voluminous medical record of the young woman that I was about to see. The patient had widely metastatic pancreatic cancer with malignant ascitis and severe jaundice. I was there because her family had called for the doctor. Her admitting physician was a respected oncologist who had gone home for the night; I was there because I was on call.
After a time reviewing her chart, I walked to her room. She was surrounded by family – an elderly lady who was likely her mother; several younger women, perhaps my age, her sisters most likely; and some younger people who were perhaps her children. She was lying in her sick bed. Emaciated, bald, with pale sallow skin and yellowed eyes, her protuberant abdomen made every breath tiring. She was dying, and her family had summoned the doctor because they knew it.
I introduced myself as the doctor serving in her oncologist’s stead. They shook my hand and expressed their appreciation. Was there anything more that I could do for her, they asked. I said that we could keep her as comfortable as possible with oxygen and pain medications, if she needed them. I stood next to her bed for a bit; I needed to be present.
This afternoon, I am thinking of Lessing’s painting and of the many dying patients by whose bedside I have sat or stood because many in my peer group (and I) are fast approaching the last decade of life. Among my friends and family there have been emergency surgeries, orthopedic procedures, cancers, strokes, pulmonary emboli, and most of the infirmities of aging. Having been retired for over a decade, there isn’t much that I can do for them but listen to their concerns, express compassion, perhaps hold their hands, and be present for them.