There is a small window of opportunity that occasionally opens when least expected.
A moment where clarity strikes, piercing as an arrow.
It comes as I leave a patient’s room.
Not always, but sometimes.
When they think I can’t hear them.
A parting shot. 1/
A moment where clarity strikes, piercing as an arrow.
It comes as I leave a patient’s room.
Not always, but sometimes.
When they think I can’t hear them.
A parting shot. 1/
The days in the hospital stretch interminably, as they always seem to do these days.
Different things keep me going on different days.
Sometimes it’s the teamwork.
Sometimes it’s the mindset, one foot in front of the other, just keep swimming, whatever you want to call it. 2/
Different things keep me going on different days.
Sometimes it’s the teamwork.
Sometimes it’s the mindset, one foot in front of the other, just keep swimming, whatever you want to call it. 2/
And sometimes the thing that keeps me going is the love of this great and wondrous and messy and terrible and miraculous endeavor that is medicine.
The thing that’s supposed to keep me going.
The beating heart of all this.
The calling, right? 3/
The thing that’s supposed to keep me going.
The beating heart of all this.
The calling, right? 3/
I enter a patient’s room.
Communicating effectively with patients is a skill. A skill that can be taught, and that is definitely learned.
It comes with training, and with practice, and lots of feedback.
And no matter how comfortable you are with it, you’ll make mistakes. 4/
Communicating effectively with patients is a skill. A skill that can be taught, and that is definitely learned.
It comes with training, and with practice, and lots of feedback.
And no matter how comfortable you are with it, you’ll make mistakes. 4/
Don’t speak too fast.
Simplify terminology, avoid jargon.
Ask to make sure. Keep eye contact. Pause for questions. Roll with interruptions.
Look for understanding.
There are wolves baying in the darkness of the forests. You might not hear them, but the patients can. 5/
Simplify terminology, avoid jargon.
Ask to make sure. Keep eye contact. Pause for questions. Roll with interruptions.
Look for understanding.
There are wolves baying in the darkness of the forests. You might not hear them, but the patients can. 5/
I’ve always wondered why effective scientific communication wasn’t taught in med school. Maybe it is, now.
Leaving the room, I overhear something just as I close the door behind me.
“Well, don’t you feel better now?”
The parting shot, when they think I can’t hear them. 6/
Leaving the room, I overhear something just as I close the door behind me.
“Well, don’t you feel better now?”
The parting shot, when they think I can’t hear them. 6/
Sometimes the words are reassurances.
“See mom? It isn’t that bad.”
Sometimes they’re words of dismay.
“Oh God…”
Sometimes they lift me up.
“I like him.”
Sometimes they crush me.
“I’m so sorry dad.”
I always pause when I hear them. Often, they are unfiltered truth. 7/
“See mom? It isn’t that bad.”
Sometimes they’re words of dismay.
“Oh God…”
Sometimes they lift me up.
“I like him.”
Sometimes they crush me.
“I’m so sorry dad.”
I always pause when I hear them. Often, they are unfiltered truth. 7/
On my drive home, I call my parents. I’ve done this every day since I went to college, every day of my career.
Speaking to my mom and dad is a privilege.
I know that one day they won’t be there anymore, and my heart will be an ocean of things I wish I could tell them. 8/
Speaking to my mom and dad is a privilege.
I know that one day they won’t be there anymore, and my heart will be an ocean of things I wish I could tell them. 8/
My dad picks up. We talk about football, because sports are how we transition into deeper subjects.
He asks me how my day was.
I tell him I’ve been thinking about the parting shots, the last words that patients leave us with.
“You mean Parthian shots,” he says.
“I do?” 9/
He asks me how my day was.
I tell him I’ve been thinking about the parting shots, the last words that patients leave us with.
“You mean Parthian shots,” he says.
“I do?” 9/
He tells me about an ancient Persian people known as the Parthians, who had a special military tactic.
While retreating (or feigning retreat), they would turn around to fire one last shot with deadly accuracy.
The Parthian shot.
The unexpected final arrow, piercing. 10/
While retreating (or feigning retreat), they would turn around to fire one last shot with deadly accuracy.
The Parthian shot.
The unexpected final arrow, piercing. 10/
He hands the phone to my mom. She’s more concerned about what I ate for lunch, and my mental state.
“How are you holding up?”
I tell her I’m fine. She sees right through me, as always.
“Tell me honestly.”
“There’s ghosts in the hallways, and wolves in the woods, Mom.” 11/
“How are you holding up?”
I tell her I’m fine. She sees right through me, as always.
“Tell me honestly.”
“There’s ghosts in the hallways, and wolves in the woods, Mom.” 11/
“You wanna talk about it?”
“No.”
That’s a lie. I want to talk. But I don’t have the language.
I can’t describe a fatigue that permeates the soul.
I can’t put words to a grief that’s visceral.
But I can try.
One last Parthian shot. 12/
“No.”
That’s a lie. I want to talk. But I don’t have the language.
I can’t describe a fatigue that permeates the soul.
I can’t put words to a grief that’s visceral.
But I can try.
One last Parthian shot. 12/
That window of opportunity, the moment of clarity, comes later that night.
The world has changed, in ways both deep and subtle… and so have I.
Wolves still howl, and ghosts still linger.
New days dawn.
And I’m still here.
Before I lie down to sleep, I write.
The world has changed, in ways both deep and subtle… and so have I.
Wolves still howl, and ghosts still linger.
New days dawn.
And I’m still here.
Before I lie down to sleep, I write.
• • •
Missing some Tweet in this thread? You can try to
force a refresh
