13 March 2011


I talk about my daughter a lot at work. When a child has a fever and cough and there is nothing I can do to make him get better faster, doesn't it help to be able to tell his parents that I have been through the same thing too? Yes, it is hard. Yes, it is heartbreaking to sit up in the middle of the night and rock a fussy toddler or infant, but you do get through it.

There are times I worry I am over sharing, but also times when I know that telling stories about Emmaline (who doesn't want to hear stories about Emmaline??) is exactly the right thing to do. One father, in particular, stopped me on my way out the room to say, "Thank you so much. You don't know what it means to have a doctor who has children. It makes all the difference."

Well, thank you in return for providing me an audience. I love nothing more than talking about my beautiful and brilliant daughter.

But last night I think I may have stepped over the line. I have never been particularly adept at telling where the line is, that division between doctor and patient where everything that is real and private flows in only one direction, from them to you. That has always struck me as a little bit disingenuous. How can we expect people to share the most intimate details of their lives with us if we are not willing to do at least a little bit of the same?

We should be able to say to someone who is trying to quit smoking, I get it. I hear what you're saying and I know that it's a struggle sometimes to make good decisions that keep you healthy and stick to those decisions when it might be easier to do just the opposite. That doesn't mean I pick up a cigarette in order to see first hand what it is like to try to fight to a nicotine addition. But I do admit to patients that I find it hard as well to always do what I think is right.

Or I tell a parent whose child is screaming and throwing things across the exam room that Emmaline has temper tantrums as well. They are frustrating and embarrassing when they happen in public, but they are also entirely age appropriate. It's hard, but sometimes ignoring them (especially when a child is tired and sick and in a frightening place) is the best thing you can do.

Last night, though, was different. There was no particular benefit to the patient from sharing a little bit about my life. It happened that on a particularly busy night one of my favorite patients, Maddy, came through the ER. I had taken care of her in another hospital when she needed IV antibiotics for an infection. She had, in fact, been in the hospital quite a lot during her life because of infections such as that one, to which she was for some reason particularly prone. Despite being trapped for months on end in a small hospital room, not allowed to leave it because of the resistant bacteria she carried on her skin, she was an effusive and truly lovely young lady. Her mother, stretched thin with work and with other children and with wanting to be with her daughter in the hospital as much as possible, was also remarkably kind and gracious.

One time last year, when Daryl had brought Emmaline by the hospital on their way home from visiting friends, we stopped by Maddy's room to say hi from the hall just outside her door. Em was the only visitor she had had for weeks. Every time I have seen Maddy since, she and her mother have asked how Em is doing. So last night, when I heard about what had been going on with Maddy and realized that there was nothing I could do to keep her out of the hospital, I felt awful. She looked great. She barely had a fever. But we all knew that the bacteria that tend to cause her infections don't respond to antibiotics that can be given by mouth.

We made plans for her admission. Both Maddy and her mother smiled, despite the bad news. They were lovely. They asked how many words Em had learned since the last time that we spoke. And then I stepped over the line. I took out my phone and showed them a video of Emmaline running gleefully through our upstairs hallway. She had just finished a bath and I knew, watching her giggle and cavort, that she smelled like sweet baby soap and all things pure and good. But she was naked. She looked back at the camera and screamed and ran away, chasing a cat. Maddy and her mother laughed.

Watching the video would not take away the days Maddy would lose this time, barricaded in a single room so small she is unable to get up to move around. And someday Emmaline will be a teenager and realize some of these things that I have done with her image, the pictures of her adorable baby bum, and she will hate me. Still, Maddy had laughed. It was not much, but it was the most that I could give her. I hugged her and I told her I was so sorry she couldn't go home. She smiled and seemed to think she needed to make me feel better, not the other way around. She said she understood and that everything would be okay.

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