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Excellent comparison
Easter Sunday in the Ladies' Room
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Christian T Sinclair, Hospice & Palliative Care Doctor Kansas City Hospice & Palliative Care
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csinclair{at}kchospice.org Christian T Sinclair
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Dr. Clark, Thanks for an insightful piece to help draw comparisons to fields few would find any similarities to exist. I recall hearing this comparison from one of your trainees David Wensel. The table you include at the end could be applied across many fields and is one I will use in teaching often. I highlighted your piece on Pallimed. Thanks to JABFM for making this important piece free to the public. Christian | |||
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Jamie S. Osborn, FM Residency Program Director Loma Linda University
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josborn{at}llu.edu Jamie S. Osborn
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I read the title "Pregnancy Care: An Apprenticeship for Palliative Care?" and was immediately transported in time to my hardest day of residency, one that I spent in three ladies' rooms: Easter Sunday of 1995. The Family Medicine inpatient service was relatively quiet that day. We successfully discharged nearly all of our patients to spend the holiday time with their own families. Only two patients very different remained "in confinement" with me that day: One, a young woman laboring to deliver her first child; the other, an older woman dying of advanced breast cancer. As someone who celebrates the miracle of Easter each year, I was struck by the poignancy of our "labor" that day. I watched in helpless awe as each woman, surrounded by family in a dimmed room, labored to breathe: the one sighing through the spasms bringing in new life and the other sighing with Kusmahl breathing signifying her departure from this life. Nothing prepared me for the emotional roller-coaster of that day. I journeyed back and forth between the two wards, but could not make it through the bright bare hallways without escaping into the Ladies Room to sob uncontrollably in a stall. About mid-day, a miracle (albeit one that HIPPA would groan at) occurred. Our pagers then were antiquated verbal models, which buzzed and then croaked out whatever walkie-talkie style message the caller spoke into the phone. I was checking vital signs in the dying woman's room when my pager interrupted, "Dr. Osborn, please return to Labor and Delivery." The woman's daughter looked up with something like hope in her eyes, and said, "Oh, you are delivering a baby today?" My eyes teared as I responded, "Yes." "How wonderful! Will you tell us if it's a boy or a girl?" "Let me check with the mom first," I stammered. After confirming that laboring patient was entering transition, I mentioned to the mother-to-be about my pager's message. I asked if she would be willing for me to tell the dying woman's family when she had her baby. "I think it might help them," I added, "to hear a message of life on a day like today." "Yes, of course!" she replied. "You can tell them all about it! My pains will have a happy ending." It seemed to me that her strength to endure labor deepened, as her suffering was able to ease the suffering of another. At that moment, my role changed from observer to participant and talisman. These women became participants in each other's stories that day, as they re-inacted that eternal story of suffering and death being redeemed and transformed by life. I am amazed at the privelege of Family Medicine, of being invited into these two sacred spaces within the span of a few hours. It was a girl. |
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