Tales of Sadness and Renewal: Doctors Reflect During Story Slam
It just takes one patient to change a physician’s entire approach to medicine. This was the thread that tied together the personal stories shared by physicians at the Department of Medicine’s inaugural ‘Story Slam’ event last week.
More than 130 people listened to 15 residents and faculty members recount how compassionate, empathetic care impacted not just their patient, but also themselves.
“At the core of humanistic medicine lies empathy for patients,” said Professor Arno Kumagai, Department of Medicine Vice-Chair of Education. “We need to use the power of narratives as a whetstone to sharpen our understanding of the human condition, and that’s why events like this are so important — they create space for a dialogue to occur.”
Several speakers reflected on the sadness of loss during end-of-life care but also on the inspiring nature of the human spirit. When a patient Mena Gewarges, a first-year internal medicine resident, had met three years earlier arrived in the ER with progressive heart failure, she knew he was dying. All she as a doctor could provide was comfort. At that moment she realized that as objective as she can be, she can’t stop being human.
Professor Shelly Dev recalled witnessing the strength of two teenaged children as they came to terms with their father’s end-of-life wishes. “It is a privilege and an honour to bear witness to these people’s grace in the darkest moments of their lives,” she said.
Professor Nadine Abdullah spoke about “the profound act of being a doctor,” recalling that just before one of her patients was taken off life support, the patient’s roommate — who lived with dementia — seemed to slip into lucidity and held her friend’s hand in her final moments.
Other speakers recounted being changed by a memorable patient or an especially unique circumstance.
Professor Natalie Wong talked about “Karl” (not his real name), a 86-year-old man whose admitting diagnosis — more than 60 times — was progressive dementia with a delusional disorder. Karl would assign himself the task of counting the number of people passing through the ward, communicate with a fellow patient who had suffered a stroke through chirping sounds and occasionally demand to ‘pay his bills and close his account.’
On Karl’s last day in the ward he dressed up in a suit the nurses had found for him from the donation pile and gave a speech to everyone on the ward. He talked about St. Michael’s Hospital as a gracious place, where people understand the past, present and future. She added that to this day, a picture of Karl hangs in the nurses’ office to remind staff that if they pay close attention, there is always a Karl to be found.
Professor Michael Schull spoke of working in a small town in Iraq shortly after the first Persian Gulf War. One evening he was woken by a crowd and led to a patient’s home, where the son was afraid his mother was dying. Schull diagnosed only a dislocated jaw, so he slid his thumbs onto her lower teeth and gave a gentle push, putting her jaw back into joint. He turned to the son and announced, ‘Your mother is cured!’
“I didn’t try too hard to dismiss the family’s unearned trust, because in Iraq in 1991, there wasn’t much else to believe in,” said Schull, who is president and CEO of the Institute for Clinical Evaluative Sciences.
Allan Detsky, Wilson Kwong, Nilay Shah, Ariel Lefkowitz, and Shaury Taran organized the Story Slam, based on similar events he has worked on for the Annals of Internal Medicine. He hopes to make the Department of Medicine Story Slam annual.
“It was a tremendous event,” said Gillian Hawker, Sir John and Lady Eaton Professor and Chair of the Department of Medicine. “It was truly wonderful to hear so many stories of how physicians’ interactions with patients and their families shape their approach to medicine — and their delivery of humanistic care.”