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To orient you on this journey to save the planet and humanity by communicating LOVE, you have jumped into the second chapter of a new book, Heart Sounds: How a Stethoscope, a Magic Wand and a Fishing Pole Teach Us to Listen for What Matters Most. You can read the first chapter by exploring the archives and clicking on the post titled, “Heart Sounds” or just head to the footnote for a link.1 You are also welcome to read all the other posts. Just know they are part of a different story.
I will be sharing each chapter of Heart Sounds on this site over the next several weeks before release of the print edition in early 2024. In order to support this loving creation of a magically handcrafted book meant to be held, I need your support. Please consider becoming a Sustaining Subscriber.2 Your support will not only grant full access to the chapters as they are posted, you will also be entitled to a personalized, signed edition that will include your name in a special acknowledgement section. I also promise not to resist additional opportunities to shower you with glitter and surprises that are intended to make your heart sounds audible.
In the meantime, Welcome to Chapter 2: The Protocol of Caring of Part I: A Stethoscope of of the book, Heart Sounds: How a Stethoscope, a Magic Wand and a Fishing Pole Teach Us to Listen for What Matters Most.
I wasn't born comfortable running toward death. That took practice. To be clear, rushing to the bedside of people taking their last breath is not what hospice and palliative care teams do all day. Though medical training did explicitly teach me how to run toward a person on the verge of dying, it never taught me how to be with a person as they died. This used to be the familiar and sacred ground of families in their living rooms. As medical science has advanced, death has become institutionalized.
The indoctrination of institutionalized medicine begins with its formality. Every procedure has a protocol and every protocol a procedure. One of my very first lessons focused on how to be with people in the hospital.
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“Welcome to Patient Interviewing," Dr. Nicholson says. "The goal of this class is to acclimate you to the sights, sounds and smells of the hospital."
I survey my small group of classmates hoping to glean reassurance that I am not the only one feeling light-headed and dizzy. Despite having only been in medical school for all of two months, I already have a self-imposed expectation that I should know a lot more than I do. The thought of being "found out" or being seen as "clueless" or "ignorant" is terrifying.
I gently rub my palms against my legs to restore feeling and remove moisture. Even though I am in a small conference room with nine classmates, I feel as if I am in a dark cave, with only echoes of Dr. Nicholson's voice reverberating against my head.
"You will each have a turn to simply talk with a patient who has volunteered to allow us to visit. You won't know any of their medical history, and neither they nor I have any expectation that you will deduce their illness or treatment plan. That is not the goal."
Despite Dr. Nicholson's words, spoken with the slow and deliberate calming cadence of a well-rehearsed television psychiatrist, my fear escalates. I begin dreading Thursday afternoons, the day our weekly course meets. It feels like a bizarre version of summer camp when we'd prepare to bring flower doilies and companionship to the nearby nursing home residents. Even though I hadn't held a doily in years, it seemed a far more familiar object than things I was being expected to handle in the hospital.
My classmates and I briefly huddle in the small conference room before learning the identity of the student interviewer of the day. It is as anxiety provoking as if we were going to play spin the bottle.
"Dawn? Is Dawn here today?" Dr. Nicholson says, looking up from a page he'd just unfolded from his suit coat pocket.
"Here," I force myself to say. I would have much rather dived into a dark coat closet with a stranger than be at the head of the single-file line parading through the hospital. I feel completely out of place. My classmates and I each wear our starched, gleaming white, short doctor coats on top of our interpretation of professional doctor clothes. We look nothing like doctors. I feel like I am wearing a costume. If only it were Halloween....
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