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Education  |   January 2017
First Listen, Then Connect
Author Notes
  • From the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. cfrango8504@gmail.com
  • Carol Wiley Cassella, M.D., served as Handling Editor for this submission.
    Carol Wiley Cassella, M.D., served as Handling Editor for this submission.×
  • Accepted for publication August 15, 2016.
    Accepted for publication August 15, 2016.×
Article Information
Education / Mind to Mind / Cardiovascular Anesthesia / Central and Peripheral Nervous Systems / Obstetric Anesthesia / Ophthalmologic Anesthesia / Pediatric Anesthesia
Education   |   January 2017
First Listen, Then Connect
Anesthesiology 1 2017, Vol.126, 192-193. doi:10.1097/ALN.0000000000001346
Anesthesiology 1 2017, Vol.126, 192-193. doi:10.1097/ALN.0000000000001346
It was a typical Saturday call shift. I had arrived at 6:15 am to prepare for the handful of cases assigned to my operating room for the day. The schedule was full of procedures that couldn’t wait until Monday, except for the very last procedure. It was an ophthalmologic surgery in which a gold weight would be inserted into the patient’s eyelid to help correct lagophthalmos, a condition characterized by the inability to close the eyelid. This was an odd procedure to be posted on the weekend, as it was not an urgent or emergent case. Nonetheless, it was a case that needed to be done for reasons unbeknownst to the OR staff, so we powered through the day and it was now time for our final case.
I drew the curtains to the pre-op holding area to find a pleasant, middle-aged woman named “Jane” patiently awaiting my arrival. Jane had a noticeably large indentation on the right side of her skull partially covered by her brunette-colored wig. Throughout our conversation, Jane would periodically dab her cheek with a Kleenex as she had tearing from her constantly exposed, irritated eye. Jane described her thirteen-year war against breast cancer and her most recent battle in which a metastatic brain tumor was excised. The surgery was an overall success despite the skull deformity and the facial nerve damage that brought her here today.
While we waited for the OR staff to prepare the necessary instruments, the pre-op evaluation evolved into a deep conversation about life and the unexpected curveballs it throws at us. I listened to Jane’s touching story and then shared a personal experience.
I told her how my brother and his wife had just delivered a baby boy at 32 weeks in an emergent cesarean section. My sister-in-law was pre-eclamptic with uncontrollable blood pressures, and there was no time left. The baby had to get out. In a flurry of events, baby “John” was delivered, intubated, and quickly whisked away to the neonatal ICU where he would receive respiratory support. In the blue corner, weighing in at four pounds four ounces, Baby John was a born fighter from day one. That Saturday marked day four of life and no day given to John was taken for granted.
Jane’s predicament was similar. She remains a devoted wife of 22 years, a mother of two teenage boys, an active book club member, and a full-time taxi cab driver to her sons who haven’t smelled the inside of the DMV office yet. That’ll be in a few months when her eldest gets his learner’s permit. Between bringing the boys to basketball practices, cooking dinner and doing the household laundry, all while dealing with typical problems of teenagers; Jane’s also receiving chemotherapy weekly to keep her cancer at bay. The neuropathy in her hands doesn’t make household chores easy, nor does the rollercoaster ride of nausea she gets from her chemotherapy. Still, she fights on with a brave face for her family, not taking a single day for granted.
Jane had gone on to tell me how she came from England, was transplanted to the Deep South, and relocated to the East Coast where she and her family have come to call home. You would never guess she was from across the pond with her heavy southern twang and how she would say, “bless your heart,” throughout conversation. She opened up to me about the struggles she’s endured surgery after surgery, and the uncertainty of her future. She’d also go on to tell me her concerns of her son going to prom with a girl in the senior class, and how she wasn’t keen on the idea but would allow it if he respected his curfew. The ophthalmologist would be out of town all week and he had promised Jane that she could have this procedure done before the dance so she could take proper pictures with her son.
We shared stories as we waited on the OR staff, and she paused in deep thought for several moments… She told me of one specific conversation she had with her eldest son that has solidified in her memory. It was the talk where she knew her son had come to the realization his mom may not be around much longer despite her best efforts. Jane said her eldest son recently sat down with his mother and said, “Mom, tell me everything.” This hit home for Jane and she grasped my hand tightly. We offered up prayers and support to each other.
As anesthesia providers we sometimes forget the reality our patients are living until we truly listen to our patients. Listening is perhaps one of the most profound and basic tools we can utilize to give patients what they need. Give them your undivided attention. They deserve it. Patients going into surgery are blanketed in vulnerability and we assume the role of their confidant and caretaker. It’s uncommon that role is reversed where we are able to share in that human experience. What a privilege to use that as an opportunity to not only connect on a humanistic level, but to also fortify the physician-patient relationship. All too often physicians build a necessary wall to protect themselves, and rightfully so. However, when these rare opportunities arise, immerse yourself in the moment. Listen to your patients. Hold their hands. And connect with them. In those moments, we will hopefully rediscover the very reason we became physicians.