Becoming Comfortable With Being Uncomfortable

Have you ever wondered how your doctor feels when performing a PAP smear or prostate exam? Just sayin'....

Courage makes it possible to stay present when things are uncomfortable. Courage creates the opening for magic to occur. Learning to ask courageous questions is often critical to discovering what matters most. What comes next is a willingness to hear and honor the unexpected responses.

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Over the several weeks I have been caring for Ms. Brown as her hospice physician, I have yet to evoke a single smile from her Eeyore disposition. Which is precisely why I choose to bring out all the stops on her 88th birthday.

Brandishing a silver wand with pink sequins and feathers, I poise its tip above her head, ready to give a flick, as I ask my magic wand question.

"Make me young!" her immediate reply, spoken in keeping with the vigor of Piglet or Roo.

Exhilarated by her sudden expression of enthusiasm, I retort, “And what would you do if I made you young?”  

Without pause she replies, “I’d go shopping!” Her face lights up as brightly as the sun over a 1,000-acre wood on a mid-summer afternoon. 

One way or another, when the heart of a wish is revealed, it is a wish that can be honored. In Ms. Brown's case, it can mean anything from taking her to the corner market to purchase a packet of Juicy Fruit gum to bringing a wardrobe’s worth of personal shopping services from Nordstrom into her apartment. Either way, this simple pleasure, like all the others my patients have requested when given the opportunity to answer, is possible. In fact, it is more likely to bring Ms. Brown relief from her persistent fatigue and intermittent arthritic pain than any medication I can administer because she believes in it, and she wants it. Because it makes her feel like herself. The way she’s always known herself to be.

Discovering what matters most to people begins with humility and expands with curiosity. The real test for physicians, then, is being willing to meet the challenge of discovering our patient’s true wishes, the fulfillment of which may likely push us well outside our own professional, years-of- medically-trained-subspecialty, comfort zone.

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Tony Stanger is just out of college, spending his days as a young techie in a new start-up when he begins developing severe shortness of breath and fatigue. He eventually goes to his local emergency room where it is discovered his heart and lungs are rapidly shutting down. He is transferred to our ICU where he is put on the most advanced form of life-support machine that replaces the functions of both heart and lungs. The catch: this type of mechanical support is time limited. Eventually, the machine starts to clog and needs to be removed. Meaning, either the patient's condition needs to be reversible or alternate organs need to be identified for replacement (the latter is far easier said than done, and for a myriad of reasons, is not an option for Tony). 

When it becomes clear the machine has run its course and needs to be removed, all of Tony's medical providers gather to let him know.