Each morning of my surgery rotation, I headed towards the only room at the end of the hall on the medical floor. The bright hallway light announced my presence as it shone through the gap in the doorway of my patient’s room. Her room looked the same, with the exception of a bouquet of roses that was placed on the counter occasionally. The new rose buds had just started to bloom.
I greeted my patient quietly as I approached her bedside. It was time for our morning routine. Each morning, I asked about her abdominal pain, hoping to discover any sign of improvement, even if it was the slightest decrease in tenderness when I palpated. Maybe today, I thought. “Same as yesterday,” she whispered.
I was assigned to Lori on my general surgery rotation. She was a sturdy, middle-aged woman with a soft voice. Her bowel was accidentally cut during a hysterectomy, forming a large fistula between bowel and skin. Following the incident, she was hospitalized and treated after a resulting fasciitis. Once her fistula healed, a process that took months, her bowel would be reconnected again in another surgical procedure. While she had the option of going home, she stayed until the next surgery to avoid leakage from her feeding tubes and infection.
This period of healing set Lori on a long road that was paved with pain. She lived in chronic pain from the fistula. While her physicians delicately weighed her safety with pain relief, she learned to balance both patience and uncertainty.
One morning, the weight of the uncertainty surrounding her surgery timeline was too much for her to carry. The physicians and I entered her room to find her holding back her tears as she voiced her frustration with her hospital course. She felt defeated over the length of her stay and expressed her doubts about the surgery’s success. As she questioned if all her pain was worth it, I thought about all the days she spent away from her children. In her eyes, each day must have seemed like watching a rewound tape.
Most of all, I realized Lori’s experience crossed many gray areas of medicine. She encountered an unlikely surgical complication — one with a low but non-zero chance. The art of medicine took on a definition that I did not expect. I always understood that medicine was not an exact science; yet, I never appreciated the weight that its uncertainties can bear on patients. While the care team facilitated her healing by replacing her vacuum-assisted wound closure on a weekly basis, they could not control her body’s healing. Ultimately, they could not guarantee an exact date for her bowel restoration surgery. The questions surrounding the date and end product weighed heavily on Lori’s shoulders. The only answer was time and patience.
We stayed with her in her hospital room as she cried. After a few moments, my attending reminded her of all the obstacles she overcame to get to this point. It was a testament to her strong spirit. As he spoke, the strides of her face slowly softened. The pain and frustration were still there, but now they were met with hope. The gray areas of medicine, while filled with unknowns, left a space for hope.
The duality of words was pressed upon me. In just a brief moment, I witnessed how they brought both power and comfort to our patient. The expressed support from her doctor made her realize that although she continued on this road, she was not walking it alone.
As the conversation approached its end, she quietly laughed. The air felt light and cool. We waved goodbye to her as we left the room. I glanced back at the bouquet of roses that faced her bed. A few leaves fell near the vase, but the crisp and vibrant petals continued to bloom.
Author’s Note: This patient’s name has been changed to protect patient privacy.
Image Credit: ” (CC BY-NC-ND 2.0) by Strawbryb