Treating a Patient With a Nightmarish Condition

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We talked for an hour, her fiancé open-mouthed in the chair next to her, my pager mercifully silent, her whole story spilling out in the middle of the night. Before she was ill, she told me, she was planning to go to medical school; now, she wanted to talk to medical students about her experience as a patient.

She recounted the numerous and surprising consequences of her illness: her ongoing pain, the difficulties she encountered trying to find doctors who weren’t afraid to treat a patient with such a complex history, other doctors who accused her of seeking painkillers. She explained that after all she went through, her doctors had rescinded the diagnosis of bipolar disorder. She detailed the operations she’d had to replace the membranes of her eyes. She was witty — funny, even — showing me a picture of the son she had a year ago (“my miracle”), describing the panic that flared while she was undergoing a bladder catheterization shortly after his birth.

We moved easily between laughter and tears. She had always wanted to meet the people who took care of her and dreamed of going to the unit to see everyone, now that her eyes were open, but worried about what being back in that space would do to her fragile emotional recovery.

Then: “The doctors at the first hospital wanted to put me on a morphine drip,” she said. “They wanted to give up.”

I took a deep breath in. “Did you ever wish they had?” I asked, fearful of the answer. “Do you ever wish we had stopped?” But she shook her head. She remembered no details beyond going to the emergency room with a high fever and a rash, wasn’t even sure she would recognize the unit where she had lived for over three months.

“I really don’t think I woke up until rehab,” she said. And now she couldn’t imagine never having had her son; planning her wedding with her fiancé. Whatever we had put her through — the consequences she was still going through — it was worth it to her to be with them.

We moved on to the reason for her visit, and I was able to be her doctor again: I diagnosed an infection, treated her pain, took extra care to make sure she would get the specialty follow-up that she needed. “Thank you for listening to me,” she said, hugging me again, and then she was gone, our chance reunion at an end. Emerging from the room, I felt a bit lighter, having started to shed a burden I hadn’t realized I still carried.



Source : Nytimes