Personal stories capture medicine’s highs and lows
Associate Professor of Family Medicine & Community Health, Hahnemann Family Medicine Residency Director and Thursday Morning Memos founder Hugh Silk, MD (left) and fourth-year medical student Kara Keating Bench, MPH, are enthusiastic proponents of narrative medicine. Keating Bench was introduced to Thursday Morning Memos during her family medicine rotation at Hahnemann.
“Louise” was coming to the end of her life. The widowed matriarch of a large family left no question that remaining at home was very important to her, even as her health declined with advancing age. Clara Keegan, MD, a former UMMS Worcester Family Medicine resident, wrote about her experience as Louise’s primary care physician in a reflective essay entitled “The Rewards of End of Life Care:”
“. . . the hospice nurse called [to tell] me that Louise was anxious and scared, and had called all of her family to join her at her home. I had not seen her in the office for a couple months. I finished my office work, called my husband to let him know I'd be home a little later than usual, and chose a route home that went by Louise's house. . . . Her daughter was shocked when I arrived. She greeted me with a hug and brought me right in . . . [Louise] took a moment to recognize me, then grasped my hand tightly and expressed her fear. I gave what reassurance I could—listened to her heart, checked her pulse, and told her that she did not need to be afraid—that she was where she wanted to be, surrounded by all the people she loved the most. . . . Louise died two days later. I was not able to attend the wake but sent a condolence card, thanking her daughter and the rest of the family for listening to Louise's deepest wishes and for helping her to have a peaceful death at home. The week after New Year's, an unexpected tower of boxes of treats arrived at our office. I will treasure the attached card always because of the note within: ‘Dear Dr. Keegan, We want to thank you for your lovely card—it meant so much to us. Also for all the caring, compassion, and respect you gave our mother. I don't think you realize the calm that came over us when you came to see Mom. . . . We will always be grateful and have a special place for you in our hearts.’ . . . I am glad I am a family doctor and can be helpful and therapeutic throughout the life cycle. ‘Doctoring’ does not always mean intervening, and the times when I do ‘nothing’ are often the most meaningful.”