My first rotation as a third-year medical student, I met a man who will forever influence the way I approach my patients. He had come to the hospital because of rectal bleeding and was ultimately diagnosed with colon cancer. As I got to know him, I learned that he had fought in two wars, started a successful business and was married for more than 50 years. And he was enormous, six-foot five-inches and 280 pounds, with a voice that reminded me of Lee Marshell — think Tony the Tiger and the guy who sang “You’re a Mean One, Mr. Grinch.”
The surgeon had removed half his colon, but you would have never known it. He was always smiling, laughing and holding his wife’s hand. He would have a daily joke and would wink at his wife every time he offered me “relationship advice.” The guy was a teddy bear and in my eyes, he embodied courage and strength.
I was assigned to follow him both before and after his surgery, and he proved to be the perfect patient. Surgery was without complication, he never complained and always followed the medical plan. His recovery was going great. Or so I thought.
One day, I got off a little early and as I walked by his room, poked my head in to say good night. But as I did, I could sense something was wrong. His wife had gone home and he was sitting alone in the dark. His natural bright smile was absent and he looked depressed, not even noticing me as I walked in.
“Are you in pain?” I asked, startling him.
“No, no,” he quickly replied, trying not to look at me as he spoke. But I could see the tears welling in his eyes.
“I was…” he hesitated. “I tried to get to the bathroom, but I couldn’t make it. I just couldn’t make it.”
I remembered seeing the nurse leave the room earlier with a soiled hospital gown and Depends. I tried to reassure him that this was expected with surgery and that things would improve with time. But then he said something that really took me by surprise.
“I’m a grown man and I can’t even take care of myself and now you guys have to clean up my shit! I feel like I’ve lost my dignity.”
He then dropped his head into his hands and began to sob.
As I tried to hold back my own tears, I attempted to comprehend what this man was going through. Had I ever asked him how this illness was affecting him emotionally? Did I consider that being forced to wear Depends was actually insulting to his character? Unfortunately, the answer was “no.”
I believe dignity is a human necessity. And yet, we likely all take it for granted until the day it’s jeopardized. This patient’s hospital course had been perfect by all measurable standards, but it had never occurred to me that preserving his dignity was just as important as managing his pain.
Michael J. Fox said that “one’s dignity may be assaulted, vandalized and cruelly mocked, but it can never be taken away unless it is surrendered.” This is an incredibly poetic statement from a man who suffers from Parkinson’s disease, a condition that has slowly usurped control of his body.
I do not believe that my patient ever surrendered his dignity. Rather, I feel he did quite well considering his circumstances. However, his dignity was assaulted, and I learned that being attentive to this was crucial to his healing.
As health care providers we become proficient in calculating doses, ordering test, and performing procedures. But we must remind ourselves that our patients are human beings. Their emotional needs are just as important as their vital signs. Many of them are experiencing the worst day, week or month of their lives. We should strive to meet them there with empathy and concern.
As I sat with my patient that evening, he quickly regained his composure. He no longer wanted to talk about himself and instead told me stories about his children. I could sense that he was very proud of them. As our conversation ended he ordered me home to my own family and thanked me for “a good cry.”
When his wife returned the next day he was all smiles. His courage and strength had never really left him. They sat next to each other in the hospital bed. He held her hand and she laid her head on his shoulder. I could tell this gave him great comfort and I realized that this was something very important. That being strong for his wife, for his family, was foundational to who he was.
Our patients are our greatest teachers. They have the ability to make us feel, to remind us what is important and why we chose to be doctors in the first place. As we strive to care for them, with all the magnificence of science and technology, we must also be diligent to preserve those qualities most dear to us as human beings. We must never forget to look beyond the hospital gown and truly see our patients as they are.