I’ve had the honor of serving many fascinating individuals with life-limiting illnesses. I’ve considered them some of the best teachers I’ve ever had in the nuances of medicine and life. Treating patients who come from the medical community is a particularly unique experience for me.
I’ve tried to pinpoint why it feels different – it could be the mild anxiety that someone well-versed in my field may detect my deficits. Or – conversely – maybe it’s that I’ll make too many assumptions about what another medical professional may understand about their illness, and miss an opportunity to educate. Mostly I think it’s the recognition that those who heal succumb to the very same illnesses they attempt to heal in others.
Recently, I treated a former mentor in our hospital’s palliative ambulatory clinic. I reviewed her medical data first – “Recurrent metastatic intestinal cancer, declines further chemotherapy. Please assess for symptom management.” I studied the regimens she had previously been on, her recent scans, tried to guess which symptoms exactly I’d be assessing. Then I reviewed her demographics to get a feel for educational level, and felt that chill that comes with familiarity. She was an employee at my health center. Finally I looked at the place where I should have started – her name. A familiar one. This woman was responsible for most everything I know about the delivery of obstetric health – both in my training and personal experience. I felt crushed. I let my supervising attending know I felt this way. I still wanted to participate in her care if she didn’t feel uncomfortable with the dynamics of our new roles. I knew from prior experience that she’s a humble woman, but perhaps she may feel the need to protect the privacy of her condition. He went to ask her permission first.
My mentor graciously allowed me to assist in her palliative management. To my pleasant surprise – I felt like her doctor. I know I am. But I felt like I was. I had assumed I’d still feel like her student or patient. But that role faded away, and it felt very natural to speak openly to her about her care in an empathetic and professional manner. Could this be the developing confidence and competence I’ve been working all year on?
Later that evening, however, as if some higher part of my brain knew that it was safe to let my guard down – I did. And I was crushed again – though years had separated us from our former roles, I knew I’d be losing a teacher soon, and that still affected me.
I reflected on my past experience losing a mentor of mine from medical school. We had assumed she was unsinkable because she was in her field – a self-proclaimed “Trauma Mama” of the ER. Even when she had told us her cancer had metastasized, she hadn’t slowed down – continuing to mentor students, and in fact dabbling in her own palliative medicine training. Burning brighter and brighter until her eventual end on earth.
A passage from one of my favorite books – an Arthurian metaphor for life – brought me comfort when I lost this former teacher. It reads:
“I wanted to give you a parting gift, and I could think of nothing better than this.” He pointed to the road beneath their feet…“Roads are the sign of the wizard. Or did you know that?”
“Then remember what I say. A wizard is one who teaches by walking away, and when you can walk away yourself, you will be a wizard…. I see you don’t quite believe me,” Merlin said. “But walking away from me really is the greatest gift I can bestow upon you.”
…The very image of Merlin faded from his mind, until only a lingering voice remained, saying, “I have led you to the secret places of your soul, now you must find them again, this time by yourself.” In a moment this voice too faded away. The boy passed the bend, kicked up a puff of dust, and smiled. He suddenly knew that every time he saw a road he would think of Merlin.
My patient and current teacher emailed me later to say “It was comforting to see a familiar face.”
It was comforting for me as well.