Walking the walk

Literally…not just figuratively

I met a young man with testicular cancer recently in the hospital. Besides having from cancer, he also suffers from substance abuse disorder. As I began to get to know him, I realized that in addition to addiction, he has depression. He expressed that before cancer diagnosis, he had known that “[he would] die of a drug overdose.”

Each day I would go into the room and he would answer my questions, but the room would be dark before I walked in. He would welcome the lights when I turned them on. He had poor eye contact the first few days I cared for him.

During my weekend rounds, I asked him “have you been walking outside?” “How much time do you spend in the bed?” He told me he spends most of the day in the bed and he had been ambulatory in the room but not the hallway.

I asked him if he would want to walk with me. We walked for a few minutes and he talked. I listened. Just like the Hamilton quote…. “Talk less… Smile more…” Of course, not the entire lyrics fit, but it is “talk less… listen more.”

I facilitated him telling me his story. I listened. I facilitated by asking questions. He probably spoke 90-95% of the time while I spoke for about 5% of the time.

What’s the outcome? At the end of the conversation, as I walked him back to his room, I asked him:

me: Is it ok if I ask you one question?

Patient: Sure.

me: I know you said earlier that you had envisioned a quite bleak future for yourself. Do you think you can imagine a different future?

Patient: *silent*

Me: *silent*

Patient: I guess.

Me: Can you imagine a future where you are healthy?

Patient: I’ll try.

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Why is this a post? Because I realized something as I walked out with my fellow. She stated “you know, I have never walked with a patient like this before.”

As I think about the Sherpa metaphor and the “dancing” metaphor where we have to be only one step ahead of the patient, there are times where we just have to be a support for the patient. Someone who shows a possibility, a light (that is not the oncoming train!).

In the early part of training, many students, residents, and fellows are focused on learning. Learning the science, learning the procedures, learning the ins-and-outs of the hospital, and the logistics of being a student, resident, or a fellow. Our humanity takes a back seat. I encourage all faculty to role model the humanity and encourage the learners to continue to “just be a human being.”

Biren Saraiya MD