Wednesday, October 27, 2010

Then Sings My Soul (alternate title: The day I cried like a baby infront of complete strangers)

I apologize for my extended blogging absence.  I temporarily lost my blogging mo-jo.  Because I was working 80 hour weeks.  So I guess I temporarily lost everything but the basic functions needed to sustain life....heart beat, aerobic metabolism....you get the picture. 

I did another stint in Palliative Care last month and I loved it!  I'm fairly certain that I'll do a fellowship in PC after I finish my Internal Medicine residency.  If you're not familiar with PC, it's functions are broad.  Palliative Care docs help manage symptoms, help patients and families navigate our complex medical system, support patients and families during difficult illnesses and help in end of life care.  That barely scratches the surface of what Palliative Care involves, but I'll leave it at that for now. 

So during my Palliative Care rotation, I got to spend a few days at the Hospice House.  This is a really beautiful facility that houses patients who are often in their final days.  One afternoon at the HH, my attending suggested that I shadow the music therapist.  I'd never seen the music therapist in action, so I agreed. 

We walked into the room of a patient whom I had never met.  I introduced myself to her family and took a seat at a small table.  The music therapist took out her guitar and asked the patient's son what kind of music his mother liked.  It didn't take him long to report that her favorite music had always been hymns.  If there is one thing in this world that is guaranteed to make me cry....hymns. 

The music therapist then started strumming her guitar slowly.  The first sounds of an old familiar song.....How Great Thou Art.  

Hello there, my name is Dr. Bartlett, and I have a tendency to cry.....easily.

It was surreal as she sang:
When Christ shall come
With shouts of acclamation
And take me home, what joy shall fill my heart......
Then I shall bow
In humble adoration
And there proclaim
"My God! How great Thou art!"

She finished How Great Thou Art and went right into His Eyes are on the Sparrow.  

Breathe.....just breathe........weenie.

Then In the Garden, one of my dad's favorite songs.

Are you kidding me, lady? 

All the while, the patient is lying in her bed, eyes closed.  Peace and serenity evident in her wrinkled face.  Her son recalled her involvement in the church throughout the years....up until she became too sick to attend. 

And then.....you can probably guess for yourselves.  The final nail in my coffin. 

Amazing Grace

I tried to focus on something....anything other than the fact that I was in a room with a dying woman and her family, listening to Amazing Grace.

I generally find catheter bags helpful in these situations.  (Hum....wonder how many cc's in the last 24 hours.  Looks kind of dark.  He he....that's pee pee!)  But this patient didn't have a catheter.  Blast!
I managed to hold it together until the last verse.  The last verse is often left out, especially in all of the new-fangled versions of the song (don't get me started).  But the last verse is my favorite:

When we've been here ten thousand years
Bright shining as the sun
We've no less days to sing God's praise
Then when we've first begun

Stick a fork in me.

So there I sat.  Trying to be all professional and doctor-y, but reduced to a puffy-eyed, snot-dripping, tear-streaming, blubbering mess.  Seriously.  I was crying so hard I could barely speak.  In a room full of strangers.

I was sure that the patient's son thought I was nuts, but when the music ended, he put his arm around me and said, "That lump in your throat is what will make you a great doctor.  Don't lose the lump." 

The music therapist and I stepped out of the room and I tried to make a joke about regaining my composure, but I still couldn't even speak.  I spent the rest of the day with red, puffy eyes and splotchy skin.  The curse of a fair complexion....and a tender heart.