A story from family medicine

McIntosh, Kim

A story you say? One, two, three, thirty stories come to mind. My mother was just diagnosed with breast cancer. My 25 year old brother was recently hospitalized with his first psychotic episode. My grandmother died peacefully in her apartment at the Legion Complex at the age of ninety. My daughter is expecting her second child and trying to renovate her home. How stressful! My husband had a heart attack at 34 quite unexpectedly. We have two children; our younger boy has chromosomal anomalies. He is such a happy kid. I have chronic pain and haven’t slept properly for more nights than I can remember. I am 89 and I have lived a good life and yet I really don’t want to have to have to face another Christmas. I wish I could lose more weight. My husband cheated on me. Can we talk?

The privilege of the family physician is to be a part of these lives. The challenge is to leave the thinking in first person at the office when the day is done. I have been amazed, shocked, humbled and embarrassed by patients’ reactions to their environment. I have felt profound sorrow, excitement and fascination, but these emotions rarely show in their true form. My cloak of professionalism has been one quarter innate and three quarters learned and it has served me well. I feel truly honoured to be able to peer into that fifteen minute window of a life and be let in so completely that I feel it might take me over. But it doesn’t, except when it does, like last week.

My mother was diagnosed with breast cancer last week. That sounds so out of place and almost cliché. I have always known cancer is really just circling about and picking on the unsuspecting. The thirty-five year old man diagnosed with bladder cancer - unheard of! A forty-five year old is diagnosed with a deep vein thrombosis and it takes a few months to face the palliative nature of the underlying metastatic choleangiocarcinoma. Then I can also report a number of remarkable seventy some year olds who have survived numerous cancers. The stoic Serbian woman whose hemoglobin was in the 30s when she collapsed and was diagnosed with bowel cancer, transfused and then treated to cure. There are miracles from time to time. I value what a family physician can do to provide emotional support and coordinate care. I often feel that the outcome is out of our control, all of us, but I am not a religious person. I often have days where I think empathy is the only skill I can offer that might make a difference.

I told my mom about her pathology results. I probably overstepped my role as daughter. Mom has a very good GP who is a colleague of mine and this is a small town. I just haven’t practiced the role of this kind of daughter before so I will undoubtedly make some mistakes. I talked to the pathologist, the surgeon and the radiologist (not in that order and more than once) because I needed to, for me. My mother is truly remarkable and asking all the right questions. She is a vibrant, energetic woman taking it all in stride. And dad, well, he has gone on-line to print off volumes of information about DCIS from the Mayo clinic website. And I feel like I am the one faltering. My cloak of professionalism isn’t fitting quite right and I just want to keep giving my mom great big hugs.

Life is short and full of surprises. I still say it is a privilege to be human and even more so to be a family doctor. It is a privilege to be a daughter, a mother and a wife. Being the “I” in the story is both the challenge and the joy. Funny that.

Theme: Patients | Patients
Theme: Physicians | Médecins
Theme: Relationships | Relations

Stories in Family Medicine | Récits en médecine familiale [Internet] Mississauga ON: College of Family Physicians of Canada. 2008 --.




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