Frank: The ringing hospital phone startled me. As a Resident Physician 60 years ago, I spent many nights in the hospital lounge and on this night, I had just fallen asleep when a nurse, needing help with an agitated, distraught, and tearful patient, called for advice. After listening to the situation, I went to the patient's bedside to see if I could help.
Earlier that day we had operated on this intelligent and eloquent middle-aged woman to remove a suspicious tumor of the ovary, which had been discovered during a routine gynecological exam several weeks earlier. What we found surprised us all.
The tumor was malignant and had spread to many areas of her abdomen, including the liver. We did what we could by removing as much of the cancer as possible. Each of us around the operating table that morning knew our patient would develop serious medical problems following surgery and more than likely die in a relatively short time and there was little we could do to change that.
It was now up to the patient’s private physician to begin the process of explaining and informing both the anxious family in the waiting room and then the patient, as soon as possible when she awoke.
After completing the surgery, my teacher, the patient's physician, asked me to follow him from the operating room to the waiting room. Seeing us come down the hall, the family quickly surrounded us, their faces revealing fatigue, anxiety, and fear. They were eager to learn what we had found.
It was then that I watched with amazement and respect as my teacher took them to a quiet room. With considerable sensitivity and careful attention to words and phrases, he explained what was found, what could be done, and that despite the ominous findings, there still was an element of hope. As we left the room, he turned to me and said, "Always leave some hope in the room, it's sometimes the only medicine we have." I wondered, however, what that meant.
Later that same day, when the patient was awake and alert, her nurse informed us that she was ready to be told what happened. Standing next to the bed in the recovery room and listening to her physician explain what he had found during surgery, I was once again impressed.
Ever so slowly, and with compassion in his voice, he gave details in such a way as to be easily understood, while explaining what he had found and what would happen next. While being honest and open about what had been found at surgery, whenever possible, he reassured. Finally, he took her into his arms and told her how sorry he was that she had to go through this. After we left her bedside, he turned to me again and said, "The only words that work here are I'm sorry. Do not try to say more."
Moments later, over a cup of coffee and in a somewhat pensive mood, my teacher continued to explain that he felt our job as doctors was to help our patients clearly and openly understand what was happening to them and with sensitivity help them through the inevitable stages of dying.
He emphasized that we had to understand the importance of these stages and know that patients needed to deal with each stage on their own time schedule and in their own way. Our job as physicians was to control pain, offer medical and emotional support as much as
possible and be good listeners. The hope he believed important to leave with his patient and her family that day was not the hope of a cure. My teacher explained to me that the hope he wanted to leave with his patient was the hope of acceptance, control of pain and peace. “Each day alive is precious,” he exclaimed, “I hope our patient can find comfort, peace, and closure to her life. This is the hope I wished to leave with her.”
That important lesson helped me as I sat on the patient's bed so many years ago, holding her hand and listening to the grief and disbelief she was feeling. It was reassuring to me as a young physician to know that I did not have to speak. Just listening would work and that when it was time for me to say something I would know what to say. I learned much about medicine that day. I learned how a physician should handle the certainty of death without overlooking life that was left to live.
Mark, I wonder what you think of this story that happened so many years ago while I was a young physician. Has hope been a tool that you have used in your work as a man of faith?
Mark: Frank, you offer such a vivid example of the beauty of never denying the possibility of hope, nor diminishing the promise of each day we continue to draw breath — to live — even, and perhaps, especially — in the face of uncertainty, or even more, when facing the very real certainty of a terminal diagnosis.
Faith is meaningless if it exists without offering the invitation to hope, whether for a better future, or a degree of comfort or a release from pain and suffering.
What your teacher, the physician, taught you about the healing power of hope, was similarly taught by the ancient rabbis of the Talmud centuries earlier. They wrote that one who visits the sick removes a certain percentage of what ails them. They did not necessarily mean this as a medical outcome, but rather as a psychological response.
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Those who visit with gentleness, with calmness, and with softness of tone of voice. and through their touch or embrace, reduce the feelings of pain or discomfort of the patient, even for only the moments they spend surrounding the bedside.
Their very presence provides relief, even when there is no longer a sufficient remedy for the patient’s illness. Their care provides hope and uplift, even when there is no longer a cure.
Their resilience, the courage to remain nearby, to stay close to the dying, despite their own fears and vulnerabilities, tells the terminally ill person that their lives continue to matter to those who love and cherish them, each day they live…even, especially, as they reach the end of their days.
The ultimate hope we extend to others is the hope that we have not written them off, nor given up on them, even in the face of a horrible diagnosis, even confronting a vicious disease, for which there is no cure. The greatest hope we instill in them is that their lives matter deeply to us. The ultimate hope is that neither they, nor we, will be cast aside or forgotten.
In the end what matters most is this. This is how we can heal and comfort, even when there is no cure. That is the best remedy we can offer. It may not bring about a miracle, but sometimes just being there, sometimes just drawing near, can mean the world to a frightened and lonely person who lies in that hospital bed. Sometimes it can be miraculous enough.
Rabbi Mark Schiftan can be reached at mschiftan@aol.com Dr. Frank Boehm can be reached at frank.boehm@vumc.org
