Cure Sometimes, Comfort Always

Sometimes the best on-shift lessons come not from being on the front lines of a code - but from being the shoulder a patient's family leans on.

I had a unique experience in medical school where I was able to complete an entire year of clerkships at a rural hospital as the only medical student without residents — a tremendous opportunity to learn.

Very shortly after arriving at my site I was given a pager. I was placed on the call list for all cardiac arrests, trauma activations, and rapid medical responses. This turned out to be very good for my education as I was paged quite frequently. I was able to participate in multiple cases where high-level, aggressive critical care was needed.

I recall one time being paged for a cardiac arrest in the ED. Normally I would participate in providing direct patient care; however, this time it was different. As I walked into the ED, I headed toward the resuscitation room. On my way I passed a crying woman. I arrived to find a middle-aged man in cardiac arrest. A team of nurses and doctors were assembled, working on him vigorously. My first instinct was to grab a set of gloves and assist in the resuscitation. In this room the gloves are in the corner, and with everything that was going on it was just easier to go outside the room and grab them from a cart. As I did that, I saw the same crying woman again. I reached for a pair gloves and turned back to go join the resuscitation team.

But then I stopped.

I'm not exactly sure why I paused. I was there solely to learn medicine, and certainly what was happening in the room — however unfortunate — was an excellent learning opportunity. Yet instead of going in the room, I turned to the crying woman.

She was the patient's wife.

She had brought him into the hospital because he had been feeling ill all day. He was being admitted to the hospital, and the hospitalist had just completed performing a physical exam when he went to cardiac arrest. Since that time everyone had been so focused on helping her husband no one had a chance to talk with her.

I can't imagine what she felt. Part of me wanted to go in the room to participate in the resuscitation, but instead I stayed with her. For some reason I felt that was more important at the time. I think I figured I had been part of many cases of cardiac arrest, and there were so many people in the room her husband was well-cared-for without me. I knew I could have a greater impact if I stayed with her.

She couldn't stop crying. We were standing outside the resuscitation room, but we could see everything that was happening. For the uninitiated I imagine what she saw seemed barbaric, the things we do to "help" people.

I proposed we find a seat somewhere so I could explain what the team was doing — but also because she seemed so distraught. I thought it best to spare her from the sight of the ongoing resuscitation of her dying husband.

She kept saying over and over again something about her children and how would she tell them. She sometimes would plead with God to save her husband. At first, I tried explaining everything in very clinical terms. She just kept crying.

At some point I remember stopping and just saying how sorry I was. I was sitting next to her on a hospital bed. She couldn't see my face, but I had started to cry as well. I sat with her, my arm around her shoulders, as they worked to save her husband's life.

It was about 10 minutes later when they were able to get a pulse. She was so happy and so thankful. In my mind I knew her husband's prognosis was grim. He had been in cardiac arrest for a rather long time, and though he had "survived" his cardiac arrest, the ultimate outcome was likely not pleasant. I did not share this with her. Maybe this was the best outcome in a sense, as now she would have more time to process it all.

She thanked me just before she and her husband left on an ambulance to a larger hospital that offered a higher level of care. I wished them both well.

This was one of the hardest days in my medical career so far. The experience remains etched in my brain. My takeaway is that I have so much more to offer than my medical knowledge or clinical skills. Sometimes just being there — to talk to, to comfort, to alleviate suffering — might be what's most important and needed.

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