ֱ

When the Patient Becomes the Healer

— Hope from an unexpected place

MedpageToday

Listen and subscribe/follow on , , and , so you don't miss the next episode. And if you like what you hear, a five-star rating goes a long way in helping us share the story side of medicine!

This story is from the Anamnesis episode called Scar Tissue and starts at 16:17 in the podcast. It's from Ashanda Saint Jean, MD, an obstetrician-gynecologist in Kingston, New York.

Little Jedan. My first and oldest nephew was born in the summer of 1994. He was weighing in at almost 10 pounds. And, as they say, it took a true village to raise him, as his parents were no longer together. My eldest brother, whom he was named after, was in medical school, and his mother was pursuing a nursing degree in Maryland.

Little Jedan, as we affectionately called him, would travel back and forth from Maryland to New York to stay with his paternal grandparents for long weekends, summers, and holidays. He was often spoiled tremendously. And he brought so much joy to the lives of all his aunts and uncles and his grandparents. He also traveled extensively with his paternal grandmother -- who he called Mama -- to most islands in the Caribbean. He was so kind, he had such beautiful big, almond-shaped eyes, and he was often so endeared by so many around him, as he grew throughout the years.

And later on, as I went on and traveled down the road of getting married, he was so protective of me leading up to my wedding that he actually asked my husband, "Can I holla at you outside? Because this is my Aunt Shanda. And you have to treat her right. And I don't want anything, anyone not treating her right." And my fiancé just looked at him and laughed. So, we went on to the wedding. And Jedan never left my side the whole wedding day, which was one of the most joyous occasions of my life.

Four months later, we found out he was diagnosed with a very severe cancer diagnosis, which would end up taking his life.

He was a football player. He was 6'1 in height and over 200 pounds in weight. And at his first game of the season, there were scouts coming to look at him play in his junior year. My younger brother, who taught him tennis in his childhood, went to see him play football. And at the game, he noticed he was favoring one shoulder more than the other. And later on that evening, my brother said to Jedan, "You need to give me 25 push-ups because I need to make sure there isn't any injury to your shoulder." And when he went to get on the ground and do a push-up, he couldn't even do one.

His mother would later take him to the hospital and to the physician to be evaluated to make sure he didn't have a torn rotator cuff. And that's how we found out he was diagnosed with osteosarcoma.

The Night I Heard the Diagnosis

The night of hearing that diagnosis, it still runs in my mind, because I came home from work. And it was just a wonderful day. And I got a call from his mother, who was screaming on the phone. She told me that my little Jedan was just diagnosed with bone cancer. I collapsed on the floor in my house. And I actually collapsed right there on my stairs, from the words that she was saying to me over the phone. It was at that point I literally ran out of my house with no shoes on, with no keys, and ran down the street to my mother's house, so I could inform her of this crazy diagnosis that they had given her eldest grandson. And when I arrived at her house, I guess I was in such a panic, in such disarray, and with such a horror, my mother didn't even know what was going on. She didn't know if I was attacked. If I was beaten. I was just so hysterical. And I was trying to explain to her that I had received this news about our little Jedan, and that he was diagnosed with bone cancer.

Jedan put up a courageous fight. He started out with chemotherapy. And then, later on, had surgery where his humerus was removed and a prosthetic was placed. We were hopeful that this would turn the corner and give us a chance, and give my nephew the chance at life he so truly deserved. However, after a very courageous fight, he lost his life after 15 months. It was horrible. He agreed to do everything we tried to do to save him: chemotherapy, radiation, holistic care. He was eventually placed on hospice at home, and he passed away on January 21, 2012, at the age of 17.

Being present with him that day that he passed, and attending the funeral services, I was overcome with grief and despair. I took a leave from work for 2 weeks and only returned reluctantly because I had no more time left. And although I was still grieving the loss of my eldest nephew, and at times was inconsolable, I had no option but to return back to work as an attending physician in ob/gyn.

Frozen in Place

My first day back at work was the hardest and longest day. And seeing patients that first day, I barely made it through the morning session. And after lunch, I went to see my first patient of the afternoon. And in my head, I'm thinking, "Wow, I did this. It's halfway over, I can go home soon." And at least I can breathe and figure out how I can face the next day. And face the reality that my nephew was no longer here with me.

And, so, my next patient was a new ob patient. She was there in the room, very polite, beautiful young lady. And being an old-school doc, I can't really type without looking at the keyboard. So I kind of just focused on the keyboard and plucked away at the keys to put in all of her medical history.

And as I'm asking the questions, the first question I ask is, "Any medical problems?"

When she said, "I have bone cancer," I could barely respond. I was almost like frozen in place.

I looked up and I looked at her, eye-to-eye, and I said, "You had bone cancer?"

And she said, "Yes."

So then I quickly glanced back at the computer because I did not want to start crying. I'm holding back the tears and trying to be as strong as I could. And it was at this point that I noticed she had the same birthday, exact date of birth and year, as my nephew who just recently passed away. The same as my little Jedan.

And so then I asked her, I said, "Well, how do you, how do they treat this bone cancer if you had bone cancer? And where did they treat you?"

And so she told me that she was in the Dominican Republic when she was diagnosed. And she went through chemotherapy and ultimately had a hip replacement that saved her leg. And that's how they were able to save her leg and continue. And she was able to continue to be able to walk. And you know, at this time, I think I got shivers across my whole body and goosebumps. And I just, you know, I couldn't hold back and the tears were welling up.

So I quickly excused myself and apologized to the patient and went straight to the bathroom. I didn't want anyone to see the amount of crying and grief that I was experiencing, and just the utmost despair that had come across my whole being. Being in the presence of this young lady with the same birthday and the same year that my nephew was born. And also to have the same diagnosis. However, he didn't survive. It took his life. But she was here to live another day, to walk another step.

So I was able to collect myself and went back in the room and again apologized for leaving so abruptly. And I wanted her to know that she was important, and that I wanted to take the best care of her, and that she deserved the best care during her pregnancy.

And so I asked, "Will you tell me more about this diagnosis?" And so she told me about the complexity of the diagnosis, and how she went through the treatment, and how she survived it.

So I told her, "Well, please excuse me, if this is not what I'm supposed to do. But, you know, I just lost my nephew to the same illness, osteosarcoma, bone cancer."

So I had to tell her this, because this came truly from my heart and from my soul, and from my spirit, and I told her, "You are supposed to be here, you are a miracle. And you are a very, very important person. And just know your presence on this earth is going to make such a difference for so many people."

And then I couldn't help but start crying again, like I am right now. And so she said, "Thank you. Thank you so much for saying that."

My Patient Healed Me

So we finished her physical exam, and she was gathering her things because the exam and the visit was completed. She surprised me. Because as she got up, she gave me a hug. And as she exited the door she said to me, "You now have a niece, so I'll see you next time, Auntie, or as they say in Spanish, Titi."

It almost felt like my nephew was saying to me, "You're going to be okay. And I'm going to send angels to look over you."

We help our patients, but we never realize how much they help us. And this young lady has helped me tremendously over the years.

So we always kind of think as providers that we're supposed to kind of, you know, help our patients, but we don't always absorb or discuss or put a focus on the impact our patients have on us. And how it allows us to be more human, better providers, more compassionate, more empathetic, more thoughtful, you know, and, I mean, every time this woman would come in, and say "Auntie," I mean, it touched my soul.

I mean, in the beginning, it was tough. And then I just felt so happy to see her. So, I mean, I am just here to bear witness that, you know, this patient helped me in so many ways that she can never even imagine. But, most specifically, she got me through that first day back. Because I didn't know if I was going to make it.

Check out other stories from the Scar Tissue episode, including "I Can't Do This Again" and "It Is Not a Sin to Cry."

Want to share your story? Read the Anamnesis Storyteller Tip Sheet and when you're ready, apply here!