I love your pajamas
by Jed Delmore, MD
Instead of discussing the latest government regulation or health care headline – I’m sure there will be plenty of that as the year moves along – I wanted to start my first column with something personal.
At the end of a long day, perhaps 12 years ago, my partner and I, along with a pair of resident physicians, were making rounds (at a time when rounding twice daily was common). Our final patient was a previously healthy, 59-year-old woman with recurrent ovarian cancer.
A CT scan earlier in the afternoon demonstrated worsening pleural effusions, and I was explaining the options of thoracentesis vs. pleurodesis. The pros and cons of each were explained, and I emphasized that draining the pleural fluid would provide temporary relief, but chemotherapy should follow to reduce the risk of rapid recurrence.
Shannon (not her real name) was attentive and asked appropriate questions. She was a successful businesswoman, used to assessing options and making a logical decision. After 30 minutes of discussion, we agreed to place a PleurX catheter and resume chemotherapy.
As we prepared to leave, Molly, a second year Ob-Gyn resident, smiled at Shannon and exclaimed, “I love your pajamas.” I looked back at the multicolored satin pajamas and thought they were indeed pretty. I also noticed how Shannon’s expression immediately changed from contemplative to wide, bright smile.
While the rest of us looked on, Shannon explained to Molly that the pajamas were a gift from her daughter who was coming to visit from Chicago that evening. Molly then explained that pajamas would be more useful than a nightgown, should a chest tube be needed. They both agreed Shannon’s daughter should buy her some more pajamas.
Although I was supposed to be the educator that day, we finished rounds with me acquiring more knowledge than I imparted. I hope most of us care providers feel that we are caring, compassionate and attentive. But the fact is, matters other than direct patient care – such as electronic charting, documenting quality measures, and teaching – may detract from what we trained to do. Regardless of whether we are delivering encouraging or discouraging news to our patients and their families, the situation is stressful. We take much for granted, such as that data is the most important part of the discussion.
Since that afternoon with Shannon, though, I have tried to follow Molly’s lead. I will ask who is responsible for the crayon drawing taped to the head of the bed or inquire about the flower arrangement or framed family portrait on the bedside table. I may even compliment the out-of-control grandson playing with the bed controls.
Where once I was reluctant to become too inquisitive regarding my patient’s life outside medical care, I have proven that I am trainable and can still learn. That said, I still haven’t exclaimed, “I love your pajamas!”
I tell this story not only because it taught me a great deal about being a physician but also because it is how I will approach my year as president of the Medical Society of Sedgwick County. It is a role – an honor – that will require me to be trainable.
During the year, I encourage fellow members to share their concerns and views on issues that matter to them and the practice of medicine. Some of those issues may be hiding in plain sight, like those colorful pajamas, and need to be brought to my attention. So please do.