The New York Times, 23 July 2002
There’s an old saying among doctors and nurses who become seriously ill: don’t get your medical care at the hospital where you work. It brings too much embarrassment and not enough privacy.
But my colleague Catherine received most of her treatment at our hospital after she developed cancer in 1996.
I never asked her why she did this, but I suspect it stemmed from her comfort with the institution and her confidence that we would do our best.
At first, things went well. Surgery and chemotherapy were followed by a remission.
Catherine continued to work, seemingly harder than ever. Her behavior surprised none of us, who knew her as a diligent and compassionate physician, always with a smile on her face even as the rest of us groused about being overworked.
”That doctor sure was nice,” one of my patients reported after he saw Catherine.
Among Catherine’s projects was helping to run a lunch series for interns, first-year residents who are notoriously stressed and often find themselves resenting their patients.
Catherine and another colleague with cancer had devised this program to teach interns about what it was like to be a patient. They had split the interns into three groups and asked me to run the third.
But Catherine eventually experienced a recurrence of her cancer. There was much more chemotherapy. She routinely wore a scarf at work to cover her bald scalp. The additional treatments could not eliminate the cancer, which was highly aggressive. Catherine was quite open about having an incurable disease.
Last year, as her health continued to deteriorate, Catherine volunteered to speak about her illness with all three groups of interns.
She allowed me to videotape her talk, knowing that we wished to use it for teaching after she died. When the tape turned out to be of poor quality, she spent another hour redelivering the talk. Although we knew Catherine had all too few hours left, she was gracious in granting our request.
In the session, Catherine spoke with remarkable candor, and at times humor, about her experiences. There had been disbelief. Her doctors had assured her the lump would be benign even though they and Catherine clearly knew it would not be.
There had been great kindness and comfort in the face of bad news. One senior specialist had spent more than an hour with Catherine, asking more about her family and emotions than her disease.
Yet there had also been insensitivity. One doctor loudly berated a colleague’s choice of treatment in front of Catherine; another did not return her phone calls.
”I was not calling for trivial reasons,” she said.
Many at the session, accustomed to hiding their emotions, wept openly.
A few months later, I was paged by another physician. Catherine had been admitted to the hospital, I was told, and wanted to say goodbye to me. I went to her room and sat down. We spoke for several minutes. She asked how my work was going. I asked about her medical condition and her family. She was experiencing great discomfort, she said. She could no longer remain at home.
Catherine soon announced that she was tired. We hugged and I said goodbye. She died the next day. I will always remember my last encounter with Catherine as one of the great privileges I have had as a doctor, and as a friend.
The tape that Catherine left behind is filled with innumerable pearls for young physicians. When she cried on learning that she had cancer, a well-meaning doctor had quickly handed her a prescription for Valium.
But, Catherine suggested, health professionals should not be uncomfortable with such emotions. Wasn’t crying the right thing to do in this situation?
Catherine also described how some colleagues at the hospital had averted their glances when she approached. Friends, she urged, should not avoid the sick. These people had the same right to speak with her as they always had, and should be willing to do so. Just asking how she was doing, Catherine said, would be O.K.
Displaying unbelievable dignity and grace, Catherine taught us how patients cope with severe illness. And she taught us how we should care for patients. We should be frank, attentive and patient.
Most important, we should not emotionally distance ourselves from the sick.
Catherine’s decision to be treated at her own hospital was indeed a fortunate one for her colleagues.