When we approached his room, Craig was wedged in the doorway, sitting on his walker angled towards the nurse’s station. It was the first time I had set foot in a hospital as a medical student; the task was to simply chat with a patient for about forty minutes. “Craig?” one of the nurses called out. “Yep! I am Craig, at least I was before I got in here!” he replied. Something about the enthusiasm in his voice appealed to me, so I sat down next to him and struck up a conversation.
“Thanks for letting me speak with you,” I said. “I am a first-year medical student, and this is my first time in the hospital.” Craig then immediately mentioned his wife. He told me that they had been married for fifty years and that he couldn’t quite remember when they last spoke. “How did you guys meet?” I asked. Craig seemed delighted by the question. I was not there to ask about pain, or if he had taken his meds, or if he knew how old he was, or where he was. I was simply there to chat. We didn’t discuss medicine, per se. Something told me that both Craig and I needed a break from the long lists of medications and diagnoses.
Craig launched into his and his wife’s story; the memory of his wife was vibrant. When Craig was sixteen, he lived in a nearby town with his parents. His family worked as farmers, and when Craig was not working, he spent time at the drive-in restaurant down the road. There he met a waitress who repeatedly declined to go on a date with him. Eventually though, she accepted his invitation and with her father’s permission, went to see a movie with Craig. They were married a couple years later.
As Craig told me the story of how he met his wife, a longing, distant smile swept across his face. He repeated each detail three, four … maybe five times. I couldn’t tell if repeating the story to himself was related to his memory loss or if he was savoring the details of his life outside the hospital. Regardless, it became clear that Craig’s memory wasn’t great. He cycled through his story four or five times before I asked another question. I didn’t mind — my questions themselves did not really matter. Giving Craig the chance to tell his story mattered.
With each repetition of the story, Craig filled in more details. He and his wife had wanted kids but couldn’t conceive. Craig’s father-in-law owned the drive-in restaurant. His mom cried often when he was a kid, but his dad never did. He had an older brother named Josh, though he couldn’t remember if Josh was still alive or not. He had the sense that Josh had passed away but didn’t really know if he did or how. What he did know was that he loved his brother, and though he never would have admitted it in his youth, he supposed that his brother loved him too.
As the hour unfolded and the ostinato of Craig’s story simultaneously refined and obfuscated the details of his life, tears welled up in his eyes. He was embarrassed, for “being a big softie.” I told him I found his tears brave. “Just like my mother,” he repeated. “Just a big softie. I guess I am lonesome here, in this hospital. I miss my wife, it’s not the same.”
Then he told me again that his mother cried a lot, and that throughout his life he had cried a lot too. At that point, an uneasy feeling welled up in my diaphragm. Craig’s memory was disconnected — he wasn’t quite sure if his loved ones were alive. He didn’t know when he last saw his wife.
The ball of emotion that had crumpled up in my diaphragm started to tug at my sternum. I admired Craig. Despite his memory loss, his sense of self was iron-clad. He knew exactly who he was. He knew exactly what was important to him. He had a keen sense of his values. I could not begin to fathom the loneliness he felt in knowing exactly who he was but being unsure of how the world was unfolding around him. I couldn’t begin to understand the pain of almost a century of life experiences and memories reduced to fuzzy recollections and half of an impersonal hospital room. I recalled the very first thing I heard him say that day: “Yep! I am Craig, at least I was before I got in here.” Again, I told him I admired him. I told him that he was strong. He denied it. “Just a big softie.”
Suddenly, my time was up. My group mates came to let Craig and I know that I had to leave. I shook Craig’s hand. Twice. The second time he didn’t let go of the handshake. He was still crying, and the knot in my chest constricted. I wanted to cry too. “Visit any time,” he told me.
“I want to, Craig,” I replied.
Craig went back into his room. Not back to the doorway, but back to bed. Back to the disconnect of knowing who he was but not where he was, or with whom.
Two years later, before our first rotation as third years, we were warned our empathy would wane over our clerkship year. Now as my clinical rotations have come to a close, I admit my empathy has waned since my conversation with Craig. At times I’ll justify my decrease in empathy as a defense mechanism — as a way to deal with the gravity of illnesses that require inpatient treatment. At other times, I’d say the waning empathy is a byproduct of increased responsibility. It’s difficult to find forty minutes to hear patient stories — notes need to be written, orders need to be pended and patient presentations need to be rehearsed and refined. The drive to get better as a clinician can often be at odds with getting to know patients.
But throughout my clerkship year, I have remembered my very first patient interaction with Craig. It has grounded me. It has compelled me to go see my patients after rounds and just chat for a bit. Sadly, I can’t sit down with them for forty minutes and listen to their stories, as much as I would love to. But I hope that a small non-medical question here or there might help them feel seen as a person outside the hospital. Because sometimes, the patient’s dog’s name is more important than if they’ve taken their meds or if they know how old they are, or where they are, or with whom.
Author’s note: The patient’s name has been changed to a pseudonym to protect his privacy.