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
Thank you Dr Henderson for your story. Speaking truth to power is in short supply at the moment. For those who haven't read it yet, I highly recommend Henry Marsh's "Do No Harm," with many funny and tragic and frustrating stories from his British neurosurgical practice. It is probably best as an audio book so the accents are right.
We of a certain medical generation all have a story of our own Mariannes. I have retold my story of “Swayze” and every single time I will tear up. Thanks for sharing yours. I’m afraid that the current generation of residents don’t understand that the Mariannes and the Swayzes help us understand the art of medicine.
Dr. Henderson, you are a courageous and caring human. Thank you for sharing this story.
The oncologists in my small town keep prescribing more and more cancer treatments, including ICU support, in hopeless situations, rarely offering your excellent option to go home and be surrounded by everything they love. It’s sad that uninformed families go along with it because they trust the medical system to provide helpful therapies.
I agree! Dr. Henderson, maybe you don’t understand why—but her family does. You changed the end of her story for the better—at the risk of your career that day. Thank you.
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.
Thank you Dr Henderson for your story. Speaking truth to power is in short supply at the moment. For those who haven't read it yet, I highly recommend Henry Marsh's "Do No Harm," with many funny and tragic and frustrating stories from his British neurosurgical practice. It is probably best as an audio book so the accents are right.
We of a certain medical generation all have a story of our own Mariannes. I have retold my story of “Swayze” and every single time I will tear up. Thanks for sharing yours. I’m afraid that the current generation of residents don’t understand that the Mariannes and the Swayzes help us understand the art of medicine.
Dr. Henderson, you are a courageous and caring human. Thank you for sharing this story.
The oncologists in my small town keep prescribing more and more cancer treatments, including ICU support, in hopeless situations, rarely offering your excellent option to go home and be surrounded by everything they love. It’s sad that uninformed families go along with it because they trust the medical system to provide helpful therapies.
Marianne's family will never forget your compassion. Thank you for your courageous act.
I agree! Dr. Henderson, maybe you don’t understand why—but her family does. You changed the end of her story for the better—at the risk of your career that day. Thank you.
Thank God for doctors like you.