Words of Comfort

Katherine Lee, MS4 at UCSD SOM, GHHS Class of 2015
This story is adapted from “Solidarity Day” hosted by the UCSD Chapter of the Gold Humanism Society on February 10, 2015″

The story I’m going to share came to me more during my 4th year rotation on an acute care surgery service. But the story actually starts during my 2nd year after our First Lecture series when we read “Cutting for Stone” by Abraham Verghese. There is a surgeon in the story, Dr. Stone who’s lecturing to residents and students and asks: “What is the treatment administered by ear?” The auditorium is silent, no one knows the answer. His son, unbeknownst to him, is in the audience and answers: “Words of comfort.”

“Words of Comfort” stuck with me, and I thought that I would try to administer “Words of Comfort” as I went through my medical education. But you read the story, see these words…how does one actually administer “Words of Comfort?” I think I had difficulty doing this in practice. While I had seen many physicians and surgeons administering “Words of Comfort” to patients, I never quite felt comfortable doing as good a job as they did.

Then during my visiting rotation on this acute care surgery service, I had a really complicated patient, Nancy. Nancy was a 45 year old rectal cancer survivor and she came in for a routine follow up surgery and ended up suffering a serious complication, went into septic shock, had multiple organs that were failing, with waxing and waning mental status in the ICU. I came onto the service halfway through her time in the hospital. I’m a visiting student, still figuring out my role, and there wasn’t much I could do for her clinically, I checked her dressings, checked her ostomies, and flushed her chest tubes twice a day. Then I had to fit it in between my time in the OR and doing all of these things I have to do to make a good impression as a visiting student. I found it challenging to be true to this philosophy of words of comfort.

Then I realized a few days in, I was spending a lot of time with her, at least 15-20 min twice a day. I just started talking with her, telling her about my day, and while she never really responded, it made me feel better to try to comfort her.

I then also noticed her husband and daughter were there every day. They were there before I got there and still there after I left. I wanted to know the woman that inspired such faith and love from these people! I started talking to them and found that there was a lot of struggle about what to medically do with her. She had a large, extended family, and everyone was very opinionated. No one wanted to be the person to make that decision to end her treatment. They were also very religious, so maybe this was God’s will that she was here persisting in the ICU with the hope of getting better. I realized her husband and daughter were agonizing over what to do, troubled and despairing over having to lead the decision making. I couldn’t really do much except comfort them, “Nancy is incredibly lucky to have you and no matter what decision you make, you have been here and loved her and shared that love you have for her with me.”

Ultimately during my last week on the rotation, the family decided to end treatment for her. All during this time, I had learned more about her, she became a real person to me. Before they withdrew care, I stopped by her room that night to say goodbye, talk to her like I always did, flush her chest tubes one last time. Her husband gave me a big hug, and said back to me, “She too was lucky to have you.”

I guess I had always thought that “Words of Comfort” were words I give to comfort the patient or extend to their families and loved ones. But I never thought my own words of comfort would come back to comfort me. That was really moving for me. Then of course I go home and have half a bottle of wine and cry while I’m writing her discharge summary…

I had a moving experience with “Words of Comfort” with Nancy during this challenging rotation. What I sort of took away from this experience was that as a medical student I had multiple clinical duties to do for my patient, but it didn’t take that much more time to treat her like a real listening person even if she wasn’t listening. What I also took away was that “Words of Comfort” extend to more than just the patient, but also the family, and me because I cared. I’m hoping as I continue into my career to keep that in mind. Surgery is not an easy career and it can be hard to find connection when you have to be in the OR and have multiple other clinical duties. But a couple of minutes can mean a lot and come back to comfort you.