St Luke hospital, there is a historical church called St John the Divine. I often cannot go there because I am on the floor, but occasionally, when I lean my back against the window during morning rounds with patients, I glance at the statue of Michael the archangel, and think to myself, "Sanctuary." Part of that church burned down almost a year ago, and it was the homeless in the street that noticed that the archangel Micheal was not lit as he usually is. In many ways, he is the sanctuary for the homeless that sleep on the streets, by being lit every night.
The archangel accompanies my other patients, as I come in with my white coat, wash my hands, before the crack of dawn, and then slowly remove the curtains in a patient's room, perhaps after a long night of pain, or being awoken by the nurse to measure the temperature, blood pressure, pulse rate, or by a roommate in the same room who is moaning and groaning. Sometimes, my patients are deep in sleep, when I stand there, silent, for a few seconds, collecting my thoughts, remembering why the patient came in intially, what we did for him, what I am supposed to follow up, what new complaints might have arisen, and above all, i collect the snapshots in time if the patient had been a the hospital for more than two days. Other times, when I remove the curtain, the patient is already awake, and if s/he is near the window, and is looking out, where the archangeal statue is. In my white coat, and struggle to understand the pathology of disease, its nartual history, points of intervention, treatment, I provide a sanctuary for the physical experience of a disease by the patient.
In ways that I cannot explain through medicine, my patients are my heroes. I do not speak of the passing infection that we can treat with antibiotic, but I speak of the chronically ill, the ones undergoing surgeries, those with TB, HIV, cancer, heart and neurology problems. I know that they struggle, I think particuarly of a patient with recurrent bladder cancer, a previous drug addict, now relapsed into use of heroin, with constant pain. Coming to grips with taking his first steps towards accepting healing, accepting his value to heal, even if it involves losing his sexual function, his bladder and so on, without returning to using heroin again. He is off the internal medicine floor, and in other words, off my responsibility, and yet I followed him up as he moved from one floor to the other, and as he is now preparing to get discharged. When he stopped being in my care, I stopped being his sanctuary, for there were other doctors in other teams taking care of him. In my short few minutes visits, I saw him entubated, on SIMV, taking artifical breaths, and then I saw him on another ward, walking with this illocecal bag. I last saw him on another floor in his bed, by the window, staring into the air, without speaking to me. As he moved out of my care, the only scantuary that remained was the window, the white curtains, and the archangeal statue accross from St. Lukes.
This man, with all of his past and present struggles, is one of my heroes.
Thursday, June 25, 2009
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