{"id":2371,"date":"2017-10-17T14:50:11","date_gmt":"2017-10-17T18:50:11","guid":{"rendered":"https:\/\/blogs.nejm.org\/general-medicine\/?p=2371"},"modified":"2017-10-17T14:59:21","modified_gmt":"2017-10-17T18:59:21","slug":"be-human-be-memorable","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2017\/10\/be-human-be-memorable\/","title":{"rendered":"Be Human. Be Memorable."},"content":{"rendered":"
\"Karmen<\/a>

Karmen Wielunski, DO, is a 2017-18 Chief Resident in Internal Medicine at the Medical College of Wisconsin in Milwaukee, WI<\/p><\/div>\n

My dad died on May 11, 2003. It was Mothers\u2019 Day. I was 18 ye<\/span>ars old. Those are the easy facts. The more difficult ones are those detailing the events that led to his death. My dad was so many things \u2014 a brilliant geologist, a loving father, an inventor, a pilot, and a Vi<\/span>etnam veteran \u2014 to name a few. He survived three tours on the front lines in Vietnam, but he did<\/span>n\u2019t co<\/span>me out unscathed. He was a victim of post-traumatic stress disorder and, subsequently, progressive alcoholism. Despite numerous attempts by my family to help him, and treatment in every form imaginable, we <\/span>watched a truly amazing person become engulfed in a vortex of pain and sadness. One night he fell. There was intracranial bleeding, seizures, and then irreversible hypoxic brain injury. It was \"Police<\/a>traumatic, unexpected, and life-changing for me and many others.\u00a0\u00a0 <\/span><\/p>\n

Memories and Questions<\/h2>\n

I started residency more than 10 years later. Just like every other resident, I spent busy days and nights in the hospital caring for countless patients with umpteen ailments. I also spent a lot of time working in the ICU. Unsurprisingly, my ICU patients frequently triggered recollections of my dad\u2019s last hours in a similar setting. I very vividly remember him lying on an ICU bed connected to a ventilator. He was slightly turned on his left side, and had thick, white dressings around his head. I remember a nurse entering his room and quietly saying, \u201cTim, I\u2019m going to give you some Tylenol now for your fever.\u201d At the time I thought it was odd that she was explaining this to him. At 18 years old, I knew what \u2018no meaningful brain activity\u2019 meant, and I knew she did too. But, at the same time, her gesture was comforting to me. <\/span><\/p>\n

The more I cared for critically ill patients during residency, the more I started thinking about the providers who took care of my dad. I wouldn\u2019t call it critical thinking by any means \u2014 more like nonchalant, stream-of-conscious thinking as I walked from one patient unit to another. I wondered, \u2018Were there internal medicine residents similar to myself? Were they really tired? Was there a critical care fellow? If so, was he or she a jovial fellow? I hope so – I like jovial critical care fellows.\u2019<\/i> These random thoughts continued for years. But, the more I wondered, the more apparent it became that I actually didn\u2019t remember any of the physicians who took care of my dad. The only person I remembered was the nurse who gave him Tylenol. Initially, this was a surprising realization. In a situation where likely countless physicians, residents, students, and therapists participated in my dad\u2019s care, how was it possible that I only remembered one person?\"\"<\/a> <\/span><\/p>\n

Humans and Answers<\/h2>\n

The answer actually came to me via Twitter. In a post on September 22, 2017, Mark Reid, MD (@medicalaxioms), wrote, \u201cWhen you run out of doctor things to do for the sick person, see if there are any human things you can offer.\u201d Though seemingly simple advice, this resonated with me. It reminded my of my dad\u2019s nurse. Due to the severity of his injuries after his accident, we quickly ran out of medical things to do. The nurse, however, still took it upon herself to do human things. The Tylenol she had to give was medically useless, but she used its administration as a venue to express care from one human to another. She called my dad by his name. She explained to him what she was doing and why she was doing it, and she didn\u2019t judge his situation. Even her soft tone of voice was a much-needed juxtaposition to the chaos that had occurred up to that point. Even if it took me years to fully realize it, all of this mattered to me. Actually, it still matters to me now.\u00a0\"\"<\/a><\/span><\/p>\n

I\u2019m sure that the other members of my dad\u2019s care team were also great. I realize that circumstance and time likely also play large roles in my inability to recollect specific people at that time. However, I do think the concept of \u2018doing human things\u2019 is important to remember throughout medical training and practice. Our chosen careers often place us in a position of being participants in difficult, life changing events of patients and their family members. We won\u2019t always have the answers. Even when we do have the answers, we won\u2019t always have the solutions. But, we can always<\/i> be human.\u00a0And, as I can attest, even the smallest human acts can have a lifetime of impact.<\/span><\/p>\n

Check out this NEJM\u00a0article for a great review on\u00a0post-traumatic stress disorder <\/a><\/p>\n

 <\/p>\n

\"NEJM<\/a><\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

My dad died on May 11, 2003. It was Mothers\u2019 Day. I was 18 years old. Those are the easy facts. The more difficult ones are those detailing the events that led to his death. My dad was so many things \u2014 a brilliant geologist, a loving father, an inventor, a pilot, and a Vietnam […]<\/p>\n","protected":false},"author":1289,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[19,25,33,42],"class_list":["post-2371","post","type-post","status-publish","format-standard","hentry","category-about-residency","tag-communication","tag-end-of-life-care","tag-reflections","tag-thanks"],"yoast_head":"\nBe Human. 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