Strapping on the gloves

The time period between when you find out you or someone you love has a lesion that is highly suspicious for malignancy and getting the biopsy results back is super stressful. When you get the call that confirms your worst fear and dashes your highest hopes... It’s hard to hear. You heart races, your body goes numb, your thoughts trail off. It is really happening. What you hoped your family would never experience is meeting you head on. After the initial shock, your mind switches gears. You begin to strap on the gloves and get ready for a fight. My mom was diagnosed with thyroid cancer last fall. I can vividly remember standing next to her as she got her biopsy done. I can remember exactly where I was and what time it was and where I was going when my dad called me back to give me the pathology results. As a medical student, I had access to tons of academic papers and resources. I had done my homework. When I read the path report, I immediately knew the prognosis, the 5 yr survival rate, the 10 yr survival rate, and the treatment and its side effects. Mom’s cancer had a straightforward treatment with little to no side effects and a low metastasis rate. Her 5 year survival was 99% and her 10 year survival was 95%. But those numbers finally hit me across the face. 95% doesn’t mean that someone was just 5% dead and 95% alive. It meant that out of 100 people, 95 were 100% alive and 5 people were 100% dead. Statistics don’t mean a thing when it’s your mom. The statistics don’t care who that 5% is.

God worked in and on me a lot last fall. I learned to trust in Him for outcomes. I learned that He creates the statistics. I learned that He does indeed hold us in the palm of His hand. I learned how powerful prayer is. I learned how He provides peace in a storm. I learned how He turns fears into triumph. I learned from my experience, and I didn’t forget.

Mrs. Babydoll (I’m going call her that because I can’t use her name that is what she called me) was a sweet old black lady with a voice that was deepened by 55 years of smoking. She was THE BEST patient I’ve had this month. She was so nice and cooperative, except for when we were telling her she had to quit smoking. Mrs. Babydoll had a grandson that was tall, strong, and built to play football. He was tough on the outside, but you could see the pain in his eyes of seeing his grandma lay in that bed and not being able to do anything about it. It’s a man’s intrinsic nature to want to fix things and protect their family. He could do neither in this situation. He was helpless, and he was very uncomfortable with it. He begged me to make her stop smoking. I did my best. I told her what it was doing to her lungs. I told her the cigarettes were the reason she was going to be wearing an oxygen nasal cannula from now on. I told her that if she lit a cigarette while she was on that oxygen that she would blow herself up. She laughed, said “Well, we wouldn’t want that to happen would we baby doll?”

We fixed the problems Mrs. Babydoll had when she came to the hospital, but there were some additional weird findings on her physical exam that just weren’t adding up. The diagnosis and treatment did not explain these symptoms or their spontaneous resolution. Cancer does weird things and given her smoking history, we decided to do a CT scan of her chest, abdomen, and pelvis just to make sure there wasn’t something we were missing.

The next morning, I went to the hospital and did my morning routine. I checked all the imaging, tests, and labs on my patients. I saw the report had been finalized by the radiologist and my heart sank as I read it. I knew, given her history and the size of the mass, that the odds were stacked against her. We went in to visit her and tell her that she was going to go home that day but she had to get a biopsy before she left because we had found a mass. Her expression went flat. I could tell she knew. She knew it was probably cancer. She knew it was probably from the cigarettes. She knew that her days might be numbered. I bet you that her heart was racing, her body was numb, and her thoughts were trailing off. The smiling, jolly lady I had gotten to know was sitting fearfully facing an uncertain future. As we walked out of the room, I smiled and gave her hand a squeeze and told her it was a privalege taking care of her. She winked at me and told me to be good and thanks for everything.

That was about a week ago. Her biopsy results came back today. The prognosis is not good for her, but I bet you she already strapped on her gloves.

I can’t help but ask… Does Mrs. Babydoll have Jesus to carry her and her family through this?
That question raises other questions…. Why do I have to wonder about that? Why don’t I already know? Did I miss an opportunity?


Highway 61 blues...
I miss home.

A Voice for Misses

Neuro rotation has come and gone. It was only two weeks, thank goodness... It was not my favorite rotation by any means. The stories were so sad. Stroke patients. ICU. Severe brain injuries. Brains aren't like bones and muscles; they don't heal quite as well. These injuries are debilitating and permanent. There is some recovery, but its slow and frustrating.

I wanted to tell the story of a patient I had. I can't use her name, so lets just call her Misses. Misses was such a sweet lady. I was on call during the week, and she came into the ER with stroke symptoms. I did her exam and helped admit her to the hospital for observation and tests. She was my first patient in the hospital to follow from the begining and I followed her the whole time I was on Neuro.
The exams and tests showed that Misses had a stroke that left her paralyzed on one side and unable to speak. She was fully aware of what was going on. She knew she couldnt talk and she was frustrated. She answered yes or no questions. She could write her name on a piece of paper for you, but thats it. She couldn't write anything else. She couldn't get her brain to communicate information the way she wanted. Misses knew what she wanted to write and wanted to say, but she couldn't make it happen. The tears on her cheeks were evidence of frustration and fear.

The doctors really irked me when they were taking care of Misses. They talked across her bed about her like she wasn't there. I wanted to tell them, "SHE CAN HEAR YOU! Just because she can't talk, doesn't mean she is deaf!" When they asked her to do things she didn't cooperate with them like she did with me. She wouldn't smile her shy, toothless (but beautiful) grin for them, but would for me (that is a test for some of the cranial nerves for all you non-meddies).

Why did she cooperate with me? I didn't talk over her. I knew Misses could hear me and I acknowledged it. I saw her every morning before the doctors came in and in the afternoon before I left. I talked with her family on the phone, got to meet them in person. I adjusted her bed for her. I covered her up. I put on her socks. I turned up her tv. I got her some water. I asked her questions about her granddaughters. I treated her like a person, not a patient. Like family.

One morning during rounds with the attending (the boss doctor), we went in to see Misses and when they left, I realized that her tv controller/call nurse button was not within reach, her feet were uncovered, her tv was muted. I went back in and covered her up, she smiled, as in to thank me. I put the controller in her hand and showed her how to work it. She nodded her head and grinned again to thank me. I don't know why, but I asked her, "Misses, are you a church going woman?" She nodded yes. "Do you pray?" Yes. "Would you like me to pray for you outloud?" She grabbed my hand and squeezed and shut her eyes. I prayed over Misses. I prayed for her tongue to be loosened. I prayed for her healing. I prayed for return of strength and function. I prayed for her family. When I said amen and opened my eyes, Misses was crying. I wanted to say something, but there were no words. I wanted to stay, but I couldn't. I just smiled and said I would be back later.

I tear up thinking about that experience. Misses is basically locked in her own body, unable to efficiently communicate. She has no voice. That day, I got to be her voice.

The idea of "voice" has stirred my mind greatly. What am I using my voice for? How many of my words every day are useful? How many are pointless? Do my words tear down people? Do they help build people up? Would I be better off with no tongue? I think some days I would. Since I have the privalege of having a voice, I should probably just learn to use it properly as Solomon describes all throughout the Proverbs and James describes in James 3.

Proverbs 21:23
James 3:5-10

A Favorite Picture of mine:

Complements of My Aunt Kyla Holcomb.
Old Highway 1