in the new york times yesterday, helen ouyang m.d., wrote an essay entitled, my patient’s faithful sisters, about a patient in a persistent vegetative state coming into the emergency department, and her sisters.
the essay was lovely, and i was left wanting more, particularly about the “characters.”
the “taller sister,” with her “curly hair cut into a triangular bob,” and the “smaller sister.”
but who are these women, really?
probably domincian, since dr. ouyang works at columbia presbyterian hospital, but maybe guatemalan or mexican? probably catholic, but maybe evangelical christian, jewish, muslim, atheist? probably married, but maybe single, straight, gay? probably mothers, but maybe childless? probably housekeepers, but maybe homemakers or hairdressers or hackers or head coaches? probably chubby, but maybe muscular olympians?
their names? their style of conversation, their accents, how the dialogue flowed in spanish?
did they talk quickly?
i suspect they spoke slowly.
that’s what i’m learning, that we need to learn to slow down, and often the family members are much wiser than the doctors.
and what about the emergency department as the appropriate site of care for this patient, for these sorts of end-of-life discussions? why not the home (or the nursing home)?
our broken health care system usually means that there’s no primary care doctor or hospice doctor who has continuity with the patient and the family. hence the fragmentation and commercialization of care.
perhaps dr. ouyang would consider turning her essay into a novel. i’m left wanting more…
what do you think?
dr. phil lederer
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