Donning green scrubs and a face mask, I stepped through the door, smiling. I had first appeared in this doorway a week ago, and had shown up every morning since. All of my other patients came and went in less than a week, but Mr. Wilson was here for the long haul. His hospitalization lasted 39 days, to be exact, which overlapped almost perfectly with my scheduled time as the intern on service. During that month, we saw each other more than our respective family or friends, and this time together allowed for the creation of a deep and unexpected bond.
He had been admitted for chemotherapy, and at first, our conversations were on that topic: What symptoms was he feeling? How much hair had he lost? Were his labs showing a response? As the days progressed, he came to experience more and more devastating and life-threatening side effects, and our conversations shifted accordingly: What new issues arose overnight? Which medications would we start or discontinue that day? How long until these effects would subside?
By the time I stepped into his room that morning, the medical updates had become briefer. His clinical picture had reached a nadir, and we were waiting for his body to recover, as we buoyed him up with innumerable medications, blood products, and specialist opinions. At this point, our conversations shifted away from his medical course toward other, broader topics. With each passing day spent isolated in his room and hoping for his body to respond to and recover from chemotherapy, his mind seemed to expand. He seemed to be exploring the frontiers of his mortality while also taking stock of the life he lived. By one week into his hospital stay, we had developed a routine: I would pull up a chair and tell him the results of his daily lab tests. He would nod, contemplate for a moment, and then share the topic that was on his mind that day.
On faith in God:
The hospital chaplain had brought Mr. Wilson a Bible. He was thumbing through it when I walked in one morning. After our usual exchange of daily lab values, he switched topics and asked, “Doc, do you think my fear of death means that I don’t actually believe in God? Because if I really have faith, then why would I fear death?” His calm tone belied an undercurrent of worry.
“That’s a great question,” I said, which is my go-to answer when I don’t know how to answer. They didn’t teach us this in medical school. I searched my mind for the right words to comfort the vulnerable person lying before me. “I know that it is said that courage is not the absence of fear, but rather the knowledge that there are more important things than fear, as well as the willingness to act on the important things despite the fear being present. Maybe the same is true of faith in God?”
Mr. Wilson glanced again at his Bible. “I’ll have to think about that more,” he said.
“Me too,” I agreed.
“I had a son when I was teenager,” Mr. Wilson said one morning. “I wasn’t really involved in his life. I had my own life and growing up to do. I always assumed there would be time in the future to get to know him.” He paused to wipe the tears from his eyes. “He was killed by a drunk driver when he was just a few years old. All the time I thought I had disappeared in an instant. And I have never forgiven myself for that.”
His pain radiated throughout the room. I usually spent my days waxing poetic about antibiotics, bone marrow physiology, and types of kidney injury, but this required a different kind of knowledge and a different type of healing. My small pile of medical knowledge that I had accumulated thus far would not serve me at this time. Instead, I slowly took a few steps into that soft, squishy, messy side of flowing emotions that exists in all humans, the part that makes us “us,” even outside the practice of medicine. I pushed through the murky darkness and jumble of feelings, trying to figure out a way to translate these feelings into words.
“I can’t even imagine what that must be like,” I started. “And I won’t pretend to have had any comparable experience.” We sat in silence for a moment, letting it fill with all the emotions we didn’t have the words to express. I thought of the people I’ve loved, hurt, and disappointed. “I do know this,” I continued. “All those things that cause us to make bad decisions in our lives — youth, pride, arrogance — they mean so little now. Your grief and regret feel overpowering when confined to this small room, but your love for him will always be bigger. I see so clearly how much you love your son and how you continue to carry him within you. Maybe this is the life raft you need when it feels like you’re drowning in grief.”
He squeezed my hand.
On sacrifice and the future:
Mr. Wilson was watching the news on TV. “I don’t like where humanity is going,” he said. “So much arguing and hate.”
Mr. Wilson had served in the military. We had talked before about the pride he had taken in his work and how he had found meaning in knowing that he had played a role in his community and country. His current cancer was actually secondary to environmental exposures from his time in the service. Instead of feeling resentful, he was trying to see it as part of the overall sacrifice he had committed to when he joined the military. But some days were harder than others. Watching the country falter while experiencing his own bodily faltering sometimes made Mr. Wilson question whether his sacrifice was worth it.
With these questions, I was certainly out of my league and had no answers. I had spent most of my life in school up to that point. What did I know about sacrificing one’s life for one’s country?
Thankfully, more often than not, Mr. Wilson just needed a listening companion during these times. He would usually end these conversations with the same piece of advice to me: “Assess what talents and skills you have, what your values are, and then commit your life to work that ensures that these things align. Everything else will fall into place.”
Mr. Wilson was scheduled to be discharged the day after I went off service.
During my last visit with him, we embraced goodbye.
“I just have to say this,” he said. “I came to this hospital to get treatment and get better. I never imagined that when I left I’d have to say goodbye to a true friend.”
Share your experiences with in-depth patient conversations in the comment section.
Hailey Roumimper is an internal medicine resident in Washington, DC. She is a 2023–2024 Doximity Op-Med Fellow.
All names and identifying information have been modified to protect patient privacy.
Illustration by April Brust