We walk into the room. Today is different.
No patient schedule in hand, like usual.
I go in blind, not knowing what the next patient visit will bring and
more importantly, why they are in the clinic today.
We walk into the room.
As the door swings open, it hits the chair that was shifted more than usual.
Next to the computer sits a 94-year-old woman in a wheelchair
who is here for one last visit.
She is a familiar face,
seen multiple times over the past year for follow-ups and health maintenance;
but this familiar face seems different today.
She is accompanied by her daughter, someone I have gotten to know quite well
as we discussed the weather and COVID-19 throughout the year.
However, those are not the only faces I gaze upon today.
Unfamiliar ones.
Younger and older.
All packed into the tiny room.
Today’s visit feels different.
Maintenance of health would not be the topic of concern.
We are greeted by soft yet sad smiles.
Laced with gratitude and an appreciation between patient and physician.
Is this a goodbye or thank you?
I cannot tell the difference as we settle into the room.
What I assumed to be another 15-minute chronic disease follow-up
Turns into a 30-minute unexpected learning experience.
There are no discussions on blood pressure meds, CPAP,
or stories about her assisted living facility.
It is time to stop.
Time to go home with family. Time to withdraw and rest.
Time to say goodbye.
I do not know how to feel in this moment.
I learned, from a stranger turned familiar face,
so many things about medicine throughout the year.
I grew as a student and as a person each time she had been wheeled into the office.
But today is a different lesson:
I learn from a woman who is at the end of her life,
That medicine is not only about controlling risk factors and keeping people alive and well,
It is also about letting go — handing the reins over to the patient in a peaceful exchange.
The physician I am working with has been following her for nearly fifteen years.
From her 70s until now.
She was there as the patient outlived her friends, as her husband passed, and recently,
as she moved into her daughter’s home
to live out the rest of her life.
The love and appreciation of life in the exam room is palpable.
It is heavy and intense, but it is also beautiful.
As I look into her tired eyes, mask and all, I see a lifetime of
living and contentment. Satisfaction with her life and with the
fact that her time had come.
As I sat next to this woman and looked into her eyes, for the first
time, I understood what medicine could be.
As providers we do not prevent death, but rather prolong life.
To afford our patients years of memories. To live.
I feel my face get warm under my mask, and my eyes get cloudy.
I am happy for her and yet sad.
Sad that I must let a stranger turned friend leave.
Leave this office and never come back.
I question myself: Why do I feel this way? What is the point?
My time in the clinic is limited anyways.
In a month, I will be leaving permanently too.
And realistically,
I will never see any of these patients again.
But for some reason, part of me wanted her to keep coming back.
As we finish, hugs are exchanged between the physician and family.
But I am left with a frail, small hand on mine.
And a smile.
I look her in the eyes and say, “it was nice to have met you.”
It feels strange to have those words leave my mouth today.
Usually, it was my go-to line as I exited patient rooms in a rush
to debrief the physician on an updated medical history.
But today, those words mean something different.
They mean “thank you.”
Thank you for showing me this beautiful part of medicine,
that sometimes gets lost in the hustle and bustle,
the anxiety and stress.
As we leave the room, I linger on the “nice to have met you” exchange and
her last interaction with us.
An interaction I’d never forget.
A lesson I’ll never unlearn.
This was medicine at its best.
Image credit: Take care of me in old age (CC BY-SA 2.0) by Johnny Silvercloud
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