What a beautiful post, thank you. End of life care in the USA needs a lot of help. :( Way too much $ spent on useless treatments for people who would be better served by dying at home and in peace.
I think it was BECAUSE you were new that you had the heart to recommend to the family. I'm not saying doctor's don't have heart but it is true that EVERYONE in EVERY profession gets jaded over time. Things, no matter how difficult, become routine. Happens in the military, happens in financial sector, and for sure it happens in medicine. I guess it's a coping mechanism of sorts.
This is amazing. You gave that family such a gift. I wish more physicians had that courage. I know with my own patients, I have tried to be honest. Sometimes families hear you and sometimes they don’t. But you gave them the opportunity to realize the truth and just love their baby girl. You did the right thing.
What a beautiful and touching story. I love the part about "stubbornly clinging to her paper charts and telephones without automated assistants". She has the heart and soul of a true physician.
I had a similar one in my first year of training (January or February of 2021, COVID era), where the patient was an older woman with a full hemisphere stroke and her daughter was trying to send her to rehab. She'd of course read online that X% of people recover fully from strokes and she had unrealistic hopes.
So when the patient was out of the room, I pulled up the imaging, which the daughter clearly had not seen, explained to her in excruciating detail the angle we were looking from, what is normal, and then when she asked where the right side of the brain was I literally had to say "it's gone".
And yet, she was still talking about sending her mother to inpatient rehab for months. So I explained to her what would happen in a rehab, that she would have no visitation due to COVID restrictions, would get a little bit of therapy that wouldn't do anything, and would waste away in isolation the rest of the day and probably die alone.
All of this felt quite cruel and it was difficult to get out, but ultimately the daughter did take her mother home, which I think was the right outcome. Telling the truth is hard, but I think it's necessary in the business.
I supposed the culture is different now because nobody was threatening to punish me. Indeed, even as an intern, I had doctors come to me for advice and I got labeled as some kind of expert in breaking bad news and palliative care situations. Sometimes I wish my training path had taken me in that direction.
WOW! What a wonderful piece of writing and confession! That was such an incredibly brave thing for you to do as such a young person and I can really feel the honor and dedication that you revealed by standing up and doing the right thing. I wish there were more doctors like you. You learned a tough lesson very young, but I’m sure that it has demonstrated to all your future patients that you have the right stuff. How lucky your patients are to have you in their life.
I wish you we had you as our doctor when my sister was that same age, dying of cancer, in unbrearable pain, forced to endure unending treatments, LP's, daily blood draws and more. They knew the treatments were futile but the rule seems to be that you never give up, especially on children. All she wanted was to go home. She never did.
Her feelings and desires were never included in the conversation, decisions or care.
I became a medical journalist and physician partly to tell her story and to talk about hospice care and quality of life. You should be proud of what you did, I hope the support you're getting from all the comments to your post helps.
Dr. Henderson you made me cry with you. I’m glad that you get to set that burden aside; I can tell you (and you already know) that you absolutely did the right thing. You and Cifu are the kind of doctors we need. Human doctors. May god continually bless you and ease your burden; you gave Marianne and her family the greatest gift anyone could ever give. Quality time.
Bless you for sharing this story and for your humanity. I have had an experience with a family member who was clearly dying and the physicians did not tell him or us. Very painful.
Thank you for sharing this, Dr. Henderson. Your story moved me deeply—it’s a powerful reminder of what it truly means to be a physician. Your words brought tears
What a beautiful post, thank you. End of life care in the USA needs a lot of help. :( Way too much $ spent on useless treatments for people who would be better served by dying at home and in peace.
I think it was BECAUSE you were new that you had the heart to recommend to the family. I'm not saying doctor's don't have heart but it is true that EVERYONE in EVERY profession gets jaded over time. Things, no matter how difficult, become routine. Happens in the military, happens in financial sector, and for sure it happens in medicine. I guess it's a coping mechanism of sorts.
This is amazing. You gave that family such a gift. I wish more physicians had that courage. I know with my own patients, I have tried to be honest. Sometimes families hear you and sometimes they don’t. But you gave them the opportunity to realize the truth and just love their baby girl. You did the right thing.
That’s a lot to carry around for so many years. I believe that anyone who cares goes through this.
And God bless pediatricians. I couldn’t handle it emotionally in my medical school rotation.
I would have just asked the family how they felt about you telling them
This is a spare and beautiful essay. Your patients are very lucky.
Thank you for sharing this story.
It sounds to me like you did what was best for the patient. That is what we are supposed to do.
If I lived near the Mojave desert, I would come to you with my granddaughters.
Ben Hourani, MD, MBA
What a beautiful and touching story. I love the part about "stubbornly clinging to her paper charts and telephones without automated assistants". She has the heart and soul of a true physician.
I had a similar one in my first year of training (January or February of 2021, COVID era), where the patient was an older woman with a full hemisphere stroke and her daughter was trying to send her to rehab. She'd of course read online that X% of people recover fully from strokes and she had unrealistic hopes.
So when the patient was out of the room, I pulled up the imaging, which the daughter clearly had not seen, explained to her in excruciating detail the angle we were looking from, what is normal, and then when she asked where the right side of the brain was I literally had to say "it's gone".
And yet, she was still talking about sending her mother to inpatient rehab for months. So I explained to her what would happen in a rehab, that she would have no visitation due to COVID restrictions, would get a little bit of therapy that wouldn't do anything, and would waste away in isolation the rest of the day and probably die alone.
All of this felt quite cruel and it was difficult to get out, but ultimately the daughter did take her mother home, which I think was the right outcome. Telling the truth is hard, but I think it's necessary in the business.
I supposed the culture is different now because nobody was threatening to punish me. Indeed, even as an intern, I had doctors come to me for advice and I got labeled as some kind of expert in breaking bad news and palliative care situations. Sometimes I wish my training path had taken me in that direction.
WOW! What a wonderful piece of writing and confession! That was such an incredibly brave thing for you to do as such a young person and I can really feel the honor and dedication that you revealed by standing up and doing the right thing. I wish there were more doctors like you. You learned a tough lesson very young, but I’m sure that it has demonstrated to all your future patients that you have the right stuff. How lucky your patients are to have you in their life.
Beautiful post. Thank you for what you did for this family. As a parent who lost a child to cancer, I think what you did was super courageous.
I wish you we had you as our doctor when my sister was that same age, dying of cancer, in unbrearable pain, forced to endure unending treatments, LP's, daily blood draws and more. They knew the treatments were futile but the rule seems to be that you never give up, especially on children. All she wanted was to go home. She never did.
Her feelings and desires were never included in the conversation, decisions or care.
I became a medical journalist and physician partly to tell her story and to talk about hospice care and quality of life. You should be proud of what you did, I hope the support you're getting from all the comments to your post helps.
Thank you, Doris. I'll always remember her.
I'm so sorry that happened to you and your sister. Things are different today, in part thanks to voices like yours.
Dr. Henderson you made me cry with you. I’m glad that you get to set that burden aside; I can tell you (and you already know) that you absolutely did the right thing. You and Cifu are the kind of doctors we need. Human doctors. May god continually bless you and ease your burden; you gave Marianne and her family the greatest gift anyone could ever give. Quality time.
Bless you for sharing this story and for your humanity. I have had an experience with a family member who was clearly dying and the physicians did not tell him or us. Very painful.
Thank you for sharing this, Dr. Henderson. Your story moved me deeply—it’s a powerful reminder of what it truly means to be a physician. Your words brought tears
to my eyes.