{"id":5350,"date":"2016-04-14T20:44:49","date_gmt":"2016-04-14T20:44:49","guid":{"rendered":"https:\/\/staging.omsa.ca\/?post_type=hub_post&p=5350"},"modified":"2024-05-02T20:44:58","modified_gmt":"2024-05-02T20:44:58","slug":"something-from-nothing","status":"publish","type":"hub_post","link":"https:\/\/omsa.ca\/fr\/hub_post\/something-from-nothing\/","title":{"rendered":"Quelque chose \u00e0 partir de rien"},"author":3,"parent":0,"template":"","meta":[],"categories":[],"tags":[28,27,35],"class_list":["post-5350","hub_post","type-hub_post","status-publish","hentry","tag-mcmaster","tag-observerships","tag-reflection"],"acf":{"title":"Something From Nothing","post_content":"To protect patient privacy, names were altered in the retelling of this story.\r\n\r\n \r\n\r\nI entered the room behind Dr. McDonald and introduced myself to John and his wife. They were an older couple \u2013 likely in their 70s \u2013 who seemed pleasant.\r\n\r\n \r\n\r\nDr. McDonald hadn\u2019t briefed me about John\u2019s background and history before we entered, so I listened and watched attentively as the appointment began. John\u2019s wife, Claire, responded to the questions and guided the direction of the interview while he sat quietly opposite her, providing only the rare nod. Claire inquired about a trial for a new Lewy body dementia treatment, and I was made aware of the reason for John\u2019s visit today.\r\n\r\n \r\n\r\nClaire had brought hope with her to this routine appointment in the form of a piece of paper with details about a medication trial. The knowledge of this trial instilled Claire with the idea of possibly stopping the progression of the disease and perhaps even bringing her husband back home to her.\r\n\r\n \r\n\r\nThe medication trial was news to Dr. McDonald, and he searched it online to learn more. Claire waited in eager anticipation, and Don continued to sit contently in his chair wearing his freshly pressed clothes, tied shoes, and ball cap \u2013 all signs of Claire\u2019s love for him.\r\n\r\n \r\n\r\n\u201cYou know, he\u2019s started calling me Larry,\u201d Claire said as Dr. McDonald scanned the reports about the drug in question. \u201cHe\u2019s not remembering my name anymore.\u201d She didn\u2019t seem to expect a reply; she just needed to share.\r\n\r\n \r\n\r\nAnd with one sentence from Dr. McDonald, Claire\u2019s hope vanished from the room. \u201cIt doesn\u2019t look like this new drug is an option for John,\u201d Dr. McDonald said softly, knowing the impact of his words. He allowed for silence as Claire processed the statement and reflected.\r\n\r\n \r\n\r\n\u201cThere\u2019s only been a single twelve person clinical trial so far and recruitment is only happening at large hospitals in the States,\u201d said Dr. McDonald, gently providing additional information and answering Claire\u2019s questions.\r\n\r\n \r\n\r\nI looked at Claire and John and the only question on my mind was: Why them? This disease was something they had never asked for, never expected, and almost certainly didn\u2019t deserve. It was a single diagnosis changing the entire course of their story as it continued to progress.\r\n\r\n \r\n\r\nI\u2019m typically the type person who smiles my way through the day and waits until I\u2019m behind closed doors to let the emotions flood out. However, that day, I sat in the exam room feeling tears form behind my eyes as I witnessed this couple\u2019s journey and felt their heartbreak. Today, John was sitting in that chair, but the reality was that it could have just as easily been one of my family members or friends. So many of our lives are woven with stories of medical inflictions experienced by us or our loved ones for which relief is unattainable.\r\n\r\n \r\n\r\nThe appointment was near complete. John didn\u2019t have any major changes, and there weren\u2019t currently any new options to try. Dr. McDonald would see him again in three months.\r\n\r\n \r\n\r\n\u201cOh, does John want to get a flu shot today?\u201d\r\n\r\n \r\n\r\nA vaccine was all we could offer him.\r\n\r\n \r\n\r\n\u201cJohn, do you want one?\u201d\r\n\r\n \r\n\r\nSure, we had conveyed empathy during the check-up and the reassurance that nothing new had developed. But, medicine could offer nothing more \u2013 just a flu shot with varying effectiveness and potential side effects.\r\n\r\n \r\n\r\nI briefly left the room to retrieve a vaccine from the fridge and returned to administer it. All of ten seconds, and the inoculation was complete. The extent of our \u201cdeliverables\u201d had been reached.\r\n\r\n \r\n\r\nAll we administered was a flu shot. Would John benefit from it? Perhaps he would be shielded from the wrath of some untimely pathogens and subsequent illness and discomfort. But it would do absolutely nothing to help him \u2013 and Claire and their family and friends \u2013 better live with Lewy body dementia. It wouldn\u2019t help him remember his wife\u2019s name.\r\n\r\n \r\n\r\nI felt useless. Medicine felt useless. In this field, we rejoice in the discoveries and interventions. What happens when there simply isn\u2019t anything else to do or try?\r\n\r\n \r\n\r\nIt\u2019s reflexive to repress the moments that don\u2019t offer us hope.\r\n\r\n \r\n\r\nBut, those unhopeful moments, they need to be recognized; they are innumerable in medicine. I don\u2019t think we have to fight back tears every time they happen, like I, the inexperienced and naive medical student did. I think we can find beauty in the unhopeful moments \u2013 the beauty of humanity evolving in all of its imperfect forms. We bear witness to stories of all kinds; regardless of whether there is hope or positive news, these experiences are real and provide us with a glimpse into someone\u2019s life. There are few things more beautiful than that.\r\n\r\n \r\n\r\nThis is all easier said than done. We strive for medicine to be equal parts comfort and care but, if required to be described by one adjective alone, could probably be summed up as uncertain. But, so is life and the stories of the patients we encounter.\r\n\r\n \r\n\r\nI\u2019m learning that our practice as physicians extends beyond providing treatment and striving to attain results. We are behooved to enter into the sacred story and personal narrative of each person. Our patients, and their families, are living with a diagnosis, not necessarily suffering from it. What a privilege to bear witness \u2013 as they continue living \u2013 and observe all that their life encompasses: families, friends, hobbies, jobs, and homes, among others.\r\n\r\n \r\n\r\nIn the cases when we can do \u201cnothing\u201d there is indeed something to do. Yes, that something could be a seasonal flu vaccine, which is an important suggestion to help prevent infection. But, after meeting John and Claire, I think that \u201csomething\u201d is multi-faceted and involves much more. For each patient we care for, it\u2019s acknowledging limitations, emphasizing listening, making space for connections, and, most importantly, honouring the human experience.\r\n\r\n \r\n\r\nMegan Schlorff, McMaster University","embed_pdf":"","post_category":"Preclerkship","post_tags":[],"embed_video":""},"_links":{"self":[{"href":"https:\/\/omsa.ca\/fr\/wp-json\/wp\/v2\/hub_post\/5350","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/omsa.ca\/fr\/wp-json\/wp\/v2\/hub_post"}],"about":[{"href":"https:\/\/omsa.ca\/fr\/wp-json\/wp\/v2\/types\/hub_post"}],"author":[{"embeddable":true,"href":"https:\/\/omsa.ca\/fr\/wp-json\/wp\/v2\/users\/3"}],"version-history":[{"count":1,"href":"https:\/\/omsa.ca\/fr\/wp-json\/wp\/v2\/hub_post\/5350\/revisions"}],"predecessor-version":[{"id":5351,"href":"https:\/\/omsa.ca\/fr\/wp-json\/wp\/v2\/hub_post\/5350\/revisions\/5351"}],"wp:attachment":[{"href":"https:\/\/omsa.ca\/fr\/wp-json\/wp\/v2\/media?parent=5350"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/omsa.ca\/fr\/wp-json\/wp\/v2\/categories?post=5350"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/omsa.ca\/fr\/wp-json\/wp\/v2\/tags?post=5350"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}