As I walked onto the University of Maryland Medical Center Midtown Campus, the hallways buzzed with the energy of a new day. I pushed open the doors to the floor, excited to start my second month with a new team. As morning rounds began, one patient in particular caught my eye. A 71-year-old man with an extensive medical history. The patient had a fall 3 months ago and was hospitalized for an L1 compression fracture. He received conservative treatment and was discharged. Unfortunately, he had to return due to relentless back pain; on admission, he stated, "I could not get up from my couch." He went through a series of examinations and studies and received a diagnosis of L3-L4 discitis/osteomyelitis.
As I made my way into his room, the air was heavy with a feeling of emotional distress and turmoil. His defeated stare was penetrating, the stress from his extensive hospitalization obvious. My human instinct kicked in, and—as I scanned his face—I could sense he needed to talk but couldn't find anyone to engage with. As I finished morning rounds, my thoughts drifted back to him, and I tentatively walked back to his room. "Knock knock," I said as I stepped into the room, my eyes sweeping from side to side as I looked for a chair to sit on. I requested his permission to grab a chair, and this was the first moment a smile appeared on his face. He gave a smile but said nothing. I sat down and asked him how he was doing. I was amazed at how quickly he opened up. He recalled how badly he wanted to go back home—he was lonely at the hospital and missed his family. He elaborated, explaining how sad he was that no one had visited during his hospital stay. It felt like nobody had time for him. It was only later that I realized the profound impact my decision to sit and listen had on this patient.
From that day onward, I made it a point to go see him at least twice—once before rounds and once after lunch—to inquire about his condition and be a listening ear. Unfortunately, his care was prolonged due to a missed diagnostic test order. His initial cultures were sent for all kinds of bugs except aerobes, and a repeat biopsy had to be done as per Infectious Disease. I knew that conveying this message would be difficult, but I wanted to be the one to share this information with him. I requested that my resident grant me the chance to speak with him. I knew he was at a stage where he did not want any more diagnostic tests done and was exceptionally emotional at any negative news. The dilemma was not necessarily the test itself but the duration it took for the results to return and the fact that it would prolong his stay. I walked into his room and noticed a child on the television. I opened up the conversation saying, "That's a pretty looking child." He gave me a big smile and said that the child reminded him of his granddaughter. He then opened the photo gallery on his phone and showed me pictures of a beautiful young girl. He was the happiest I'd seen him during his entire hospitalization. My thoughts turned back to the test—should I take this opportunity to broach the subject? In a split second, I thought yes!! I utilized the U.S. National Quality Forum guidelines to disclose the error. To my surprise, he had no objections. Phew, I thought as a sense of relief flowed over me! I walked out of the room understanding the importance a strong doctor–patient relationship has on patient outcomes and care.
After 2 months on the floor medicine team, I moved to the intermediate level of care, leaving behind the patient I had grown so fond of—or so I thought. Just 3 days later, an intern from my floor team informed me that a patient wanted to see me. I was fascinated: a patient was requesting to see me? I walked back into the familiar room and the patient said, "Dr. Ahmad, you are the only one who sits by me." My simple act of sitting beside him had left an impression to the point where he was requesting to see me. As you sit beside the patient, they know you are on their team, they know you are on this journey with them. Studies have reaffirmed what I have experienced firsthand regarding the positive influence sitting with a patient can have. The patient went on to say, "Thank you for having time for me," before he pulled out a note showing my name and beside it a star. It made me realize the importance of patient interactions. This art of patient care is indeed a display of the immediate positive impact communication has on the patient.
Ahmad Sayeed
American University of Antigua
Graduating Class of 2024
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