A Mile in Their Shoes

Why won’t this cough go away?

“It’s probably nothing,” I thought to myself. “I haven’t had any fevers, night sweats, weight loss. Could it be TB? I am in Zambia after all. But I’m sure with a few more days of cough and cold medicine, this will improve. I really don’t need this right now. I have patients to care for and too many tasks at hand.”

But the cough persisted.

“It’s becoming more and more challenging to make it through rounds. I’m coughing with each sentence. I think I’m starting to develop some shortness of breath. Is this pleuritic pain? It feels like the pain I had when I was sick with pneumonia a few years ago. What could be wrong? Everyone’s read the chest X-ray as normal.

I guess I need further work-up.

“Well, the QuantiFERON antibodies, which test for tuberculosis, came back negative. That’s reassuring. But I can’t believe my D-dimers and ESR [erythrocyte sedimentation rate] are elevated — that could mean I have a pulmonary embolus [PE]. I did just travel back from the U.S. a week ago. Could this be a subsegmental PE? I don’t have the typical symptoms. Now I guess I’m obliged to get the CT [computerized tomography] scan of my chest done. Gosh, I wish my husband, Thomas, was here, I hate navigating all of this alone.

“What is this?

“The CT showed an irregularly shaped nodule taking up contrast. Stop freaking out. We don’t even know what it is yet. Stop Googling — you know better. Stop crying. It will all be OK. Stop thinking the worst. Let’s handle this one step at a time. You’ll fly back to the U.S. and get this all sorted out.”

Time for the biopsy.

“Wow, my first time at Hopkins. I wish it wasn’t under these circumstances. I’m receiving such amazing care, and they don’t even know I’m a fellow. I’m glad they don’t — that’s a good sign. It means they treat all their patients with compassion. This nurse is so warm. I like how talkative and friendly she is. It’s a good distraction, because I’m so nervous. I hope I’m not in too much pain after. I wish they allowed visitors in. I’d feel stronger if Thomas was here. It’s OK, I can do this. I’ll be fine.”

I was hesitant to share this health experience, but I felt compelled to since it brought me so much insight into what our patients experienced during this pandemic. Our patients are at their most vulnerable when they’re ill. They could be in a state of uncertainty and fear if their diagnosis is unknown. They could be grieving over bad news and a poor prognosis. They could be feeling alone even though they have multitudes of staff members constantly checking in on them. They could be battling a multitude of stressors due to the pandemic. As a physician who’s now been in the role of a patient a few times in my life, I realize how crucial every interaction with each patient is. A smile and a soft touch can make a profound positive impact, while harsh words and hasty care can leave just as strong of an effect in the opposite direction.

The pandemic made being a patient even more frightening. Imagine feeling at your most vulnerable in an unfamiliar and noisy hospital without any loved one with you due to COVID-19 restrictions. Add on having to get poked multiple times for blood or undergo a procedure you’ve never had before. What if you were already delirious to begin with? Imagine the terror. I’m grateful for my experience because now I’ve been on both sides of the hospital room. Yes, being a health care practitioner during the pandemic has been debilitating, but let’s not forget that being a patient can be just as taxing. Our patients are warriors. Many of them do all of this with a smile on their face despite whatever physical discomfort or inner turmoil they may be grappling with.

Being a patient served as a reminder to honor and appreciate life. As a physician, you may interact with countless patients every day and you may not remember most encounters. Some days you begin to feel like you’re just ticking off boxes and making sure all the work is done. But it’s startling how well you can remember every interaction once you’re the patient. Let’s strive to make these interactions full of comfort and compassion. Let’s try to walk a mile in their shoes.


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