So they set out and went from village to village, preaching the gospel and healing people everywhere. (Luke 9:6, NIV)
My first patient on my internal medicine rotation was exquisitely bald, somewhat listless, and unquestionably tooth-free. He has been admitted for vomiting and abdominal pain and was subsequently found to have a small-bowel obstruction. Because he was 80 years old and not good surgical candidate, the only course of action was to place a nasogastric tube and wait. Four days had passed when I appeared on the scene–fresh from Christmas vacation– and he became my patient.
A shockingly bright quilt adored his bed; as I approached, he cracked open an eyelid. After the obligatory introduction, “Hi, I’m a student doctor, and I’ll be taking care of you while you’re here,” I began to examine him. His abdomen was fairly distended and as I percussed, I commented: “Your belly sounds like a drum.” “A drum?!?” he exclaimed and chuckled gleefully.
Each morning– whether he was nauseated or hungry, in pain or not–we would discuss his “drum” and laugh. even though there was no magical solution to take away his discomfort, when he was given something to laugh about, he nonetheless became cheerful and optimistic. Tapping into the humor of his discouraging situation made the wait-and-see game a little more bearable for both of us.
So many times in medicine, in life, we become so inextricably entrapped in healing, working, or improving that we lose sight of the big picture. The blood pressure is controlled, but we forget to ask about the patient’s new grandbaby. The cancer is in remission, but the patient is still depressed because her hair has fallen out. The bills are paid, but the breadwinner is too exhausted to enjoy family game night.
“To make man whole,” the motto of Loma Linda University, suggest that our job is not only to treat the disease, but also, and ultimately more importantly, to treat the person in whom the disease has taken up residence. Too often it takes a situation in which our hands are tied to remind us that life in earth is not about the way it ends; it’s about what we do on the road we take to get there. Unless we care for the entire person–body, mind, and soul– then medicine and life are just work.
My parent’s bowel obstruction was ultimately resolved, and most likely would have been, whether or not his distention was likened to a drum. However, without the “drum,” I would have missed out on the smiles, the laughs, and the wink he gave as he gave as he shuffled, still chuckling, out the door.
– Lisal Folsom, LLUSM class of 2009