The Art of Caring
Josh Reiher, MD
I recall one particular encounter that I cherish. One day on service, our palliative care team was summoned rather urgently by the surgical ICU team to meet a patient who had been hovering near death in the hospital for a couple of months and was now suddenly refusing further aggressive treatment. This gentleman had struggled with esophageal cancer for several years. With progressively worsening dysphagia, he was slowly being robbed of the joys of food and drink. After several months of preoperative chemo and radiation therapy, he agreed to get an esophagectomy. While the procedure temporarily gave him relief, he unfortunately suffered through a multiple-month hospital stay with endless complications—ranging from septic shock to respiratory failure and intubation to difficult postoperative pain management.
I remember his eyes immediately, filled with warmth, gentleness, wisdom, and generosity. Despite all the pain and suffering he endured, the joy in his heart had not waned. He had a tracheostomy in place, but his voice-augmentative device was not working at this critical time. His ability to communicate had been compromised at his most vulnerable moment. He simply waved and smiled when we approached the door to his room. As our palliative care team greeted him, he attempted with futility to respond, voiceless, with a hint of frustration. He was slightly drowsy, cachectic, weak, and exhausted. His feeding tube was actively pumping liquid nutrients into his stomach, and he was the only person in the room not wearing a cold, impersonal yellow isolation gown with gloves and masks.