Most days I am the doctor listening intently as patients speak of their concerns, but that day I found myself on the unwelcome side of a stethoscope. I learned you can see a thousand patients and never know the color of the inside of a hospital quite so well as when you are the one lying on a stretcher looking up at the sagging white ceiling tiles age-stained with gradients of yellow.
It would likely be a straightforward procedure: an elective upper endoscopy to assess for the etiology of dysphagia over several months. As a diligent physician-patient, I had read up on the details of the procedure and knew—theoretically—what to expect. But it is one thing to learn about the physiology of the heart while poring over textbooks in your first year of medical school and another to feel the smallness of your knowledge when you are standing for the first time before a patient gasping from the pain crushing his chest in the emergency department. And is it one thing to academically comprehend the steps to a procedure and another to feel your own heart bruising itself against your rib cage from the panic of preparing to be wheeled off for the endoscopy to begin.
They are kind, all of them: the gastroenterology physician who asks if I am ready and whether I have any questions, the nurse who asks again if I am sure I have no questions as she works on starting an IV. My mouth forms the words before I think them—no, I’m okay, thank you for asking—and two seconds later my jaw hurts from clamping down on all the words I truly wish I could say. What keeps me from speaking all my fears? The worry of not looking good in front of an attending when I am only a resident physician? The personal reprimand that I shouldn’t be concerned over such a simple thing when so many of my patients have had their own endoscopies and done okay? And yet, when a care partner pauses by my bed in the preprocedure area to tell me don’t worry, you’ll be okay—I only clasp my hands together tighter on my lap.
This is when I hear the squeak of computer wheels approaching. I glance up at the anesthesiologist standing at the bedside, his gaze turned toward the screen and his large round glasses reflecting a checklist glowing on the monitor. He wears scrub bottoms and a sweater top with a thick turtleneck folded right up to his chin. Adjusting his glasses, he reads off the checklist: anything to eat since midnight? no prior reactions to anesthesia? any questions?
Maybe he notices each progressive no becoming smaller, the final only a hushed whisper of my breath. His hand hovers over the computer mouse, then lifts and turns off the screen. He turns toward me, his nose wrinkled and the glasses sliding lower. Without asking, without more pause, he pulls up a chair and sits down next to me.
Hey, he says, I’ve got a couple minutes. You okay? Want to talk?
I know he has more cases this afternoon, patients who need him more, and I have seen this procedure carried out many times before. After a pause, I shake my head. No, it’s okay . . . I’m just a little nervous. The words are small and clumsy, tripping over themselves as I try to say the right thing. I hug my knees against my chest. I didn’t want to bother you—
You’re not. He cuts me off, firmly but not unkindly. His eyebrows are furrowed, his gaze focused and intent, his feet planted on the floor and his hands on his knees. It isn’t bothering me at all. I’m here to help. He seems to study my face, trying to discern the tangled feelings behind my quiet. Look, he goes on, it’s a big deal. Any procedure is when it’s happening to you. Is that what’s wrong?
By now I am an inch away from crying and working hard to apply the brakes. Um . . . I guess . . . it’s just that—he is staring straight at me, there is no avoiding the collision—I’m scared of the procedure! The outburst leaves me breathless. I’d been collecting the words in my stomach where the camera would soon go, fashioning them from fear and worry. But having said them, I feel very small. I wince from the bite of guilt, wishing I were braver.
But he nods, normalizing my reaction. I totally get it. All of it, or a particular part?
His words are gentle, understanding, and they ease a little of the tension making my shoulders ache. Well . . . I guess the conscious sedation, I admit. I’ve never had anesthesia like that before.
He nods again. Ah, he answers. Makes total sense. He leans in close and lowers his voice as if whispering a secret. You know, I had an elective intubation once for a procedure. Want to bet if I cried the night before? I put people to sleep a dozen times a day, but I was scared of whether I would wake up. Let me promise you—he reaches out then and places his hand firmly on my shoulder—I’ll be there when you wake up. I know it’s scary. But you and I are a team in this, and we’ll get you through this together.
It is such a small thing, the warmth of his determined hand, but the memory is the anchor I hold onto when I am wheeled back for the endoscopy. He is already back there checking a bag of fluids hanging on an IV pole. I hear his voice—don’t worry, it’s just going to sting a moment—and a wave of warmth passes over me like a tide rising over the shore. There are ten seconds—I remember it as such—when my lungs have the desperate sensation of needing a breath, but I can’t move, can’t make a sound. Did something go wrong? I feel the grasp of panic threatening to grab my throat like claws—
But I remember his hand, remember his promise, and I trust the team enough to give in to the compassion of their care.
I wake up later to a familiar hand shaking my shoulder, shaking me back fully to consciousness. The round glasses sliding down his nose drift first into view, then his eyes fully focused on me, then his smile before he speaks the words: you did just fine, how do you feel? And the truth is I felt far better for the attentive kindness he had shown me.
Sometimes you may wonder if the small things—the extra moment taken to listen, a thoughtful and reassuring word, your hand on a patient’s shoulder—make any difference at all. I am here to say there is nothing more important. For the healing power of compassion cannot be overstated, and all it takes is making an intentional moment to reach out a welcoming hand—a kindness that will lend your patients great strength and courage.
