What's Important to Your Patient Today?

It was a Friday morning, and my attending was getting the floor together to celebrate. Several years ago, he noticed that many patients don’t have family members or friends with them at the bedside, especially if they come in frequently for dialysis or cancer treatment. It became a tradition.

I remember the patient very clearly. She was wearing a yellow scarf and her long white hair reached the top of her shoulders. I remember her Southern accent and how she spoke English, Spanish, and French fluently. Everyone on the floor loved her, and we were all excited for the surprise.

We congregated outside of her room — every nurse, social worker, doctor, and student. Then, slowly, we walked into her room one by one. 

"Did someone die?" she asked. Then, realizing it was her birthday, a huge smile lit up her face. 

Beforehand, we passed around a card to sign, and earlier that morning my attending got her a cupcake from the basement cafeteria. It was tradition for one of the medical students to lead the singing parade, so I started with my very best rendition. Thankfully, everyone else in the room began singing too. When the patient started singing with us, swaying her hands back and forth, I think we all felt her joy. Living in the moment is not something we often see from patients; no one wants to be in the hospital and it’s hard to keep positivity alive when you're sick. When we finished the song, she asked if she could have a hug. 

"TJ, the honor is all yours," my attending said. 

I moved to her bedside and gave her a big hug. And, unexpectedly, she kissed me on the cheek. At that moment, I like to think she forgot she was in the hospital. I like to think she remembered what happiness and joy felt like. For the rest of the day, she talked about how good the cupcake was (for a cafeteria cupcake) and she texted pictures of the balloons and card to her family.

About a month later, I was walking down the hallway to see a new patient. I wasn't given a lot of information, but I was told the patient's neuropathy and pain were worsening. When I knocked on the door, I didn't hear a reply. After asking a nurse if I could visit the patient, I entered the room.

It was her. She wore the same yellow scarf but her smile was gone. I couldn’t believe it was the same woman. She asked how I was doing and I asked her how she was holding up. 

"I remember you singing happy birthday to me, and the hug," she said as she smiled at me.

We talked for a while and she told me the pain was getting worse and the medications were not enough. For much of the time, I didn’t talk, just listened, as she shared her recent struggles and not having the means to care for herself. I didn’t take notes; I already knew what I was going to tell my team.

The hospital is one of the worst places in the world. Uncertainty abounds — and feeling like you may not leave the hospital the same as when you came in is scary.

Caring for patients is about more than medical care. I think you have to be willing to live in the moment and listen to what the patient is telling you. To comfort them when they are down and to celebrate happy times. Whether verbally or with gestures, you should always try to find out what is most meaningful for the patient in front of you. It's not the labs that matter. It's not the x-rays that matter, and it's not scheduling the follow-up appointments. 

What matters is what's important to the patient today — whether it's their family, their friends, their work, their pets, their projects, or their birthday. Those things reflect quality of life, how much time a patient has left to spend doing the things they love, and being with the people they care about.

Now, I always look at a patient’s chart for the date of birth, on the off chance we will be celebrating with the patient during their stay at the hospital. So far, I've had the honor of being a part of eight birthdays, and each one has a heartfelt memory attached to it. To my attending: thank you for passing on your tradition to me. You showed me that empathy is not something that is taught — it’s felt when you live for the moment with your patients.

Ton La, Jr. is a MD/JD/LLM candidate at Baylor College of Medicine and the University of Houston Law Center applying to internal medicine residency programs. He sits on the American Medical Student Association Board of Trustees as the Vice President for Membership and previously served as the Student Editor of The New Physician. He is a 2019–2020 Doximity Op-Med Fellow.

More from Op-Med