Reflection #3

Cassandra Rohm

SSO 430-22

Deborah Ciocco

12 July 2023
 Every once in a while, a day will strike you. It may be exceptionally difficult, powerful,

emotional or something else entirely. I recently had one of these days. As time has gone on, more

emphasis has been placed on the mental health of the healers of our society. There is still much

work to be done in this area and it is days like I’m about to describe that make it so important to

take care of oneself.

My day began as any typical workday does. We saw our morning patients without trouble

and had a delay until we started our afternoon session. Our first patient left a mark on me that I

won’t soon forget. He had come into the office for a follow-up after having a urological

procedure. He had been having blood in his urine for a few weeks and he had a biopsy of his

bladder. It confirmed cancer.

One would think that it would be a devastating diagnosis and for most anyone else it

would be. The story was different for this gentleman. The appointment was originally scheduled

because his children had expressed concern that the patient was depressed and they were hoping

we could prescribe him an anti-depressant. Of course, this couldn’t be done without the patient’s

consent so we called him and scheduled an appointment.

We started seeing this patient almost a year ago and I had built quite a rapport with him.

We joke and have a good time whenever he comes in and when we were speaking with his

children recently, they had commented about how he lit up when we called to check on him. The

visit started just as always does. The patient and I exchanged banter back and forth and had a

good laugh until we had to get to the reason for the visit.

With a shaky hand, he pulled a slip of paper from his pocket. He had written the

information for a hospice agency and a nurse who worked there. He explained that he wanted a
referral to initiate care and he wanted to be taken care of by the nurse he had written down. He

became tearful as he spoke and my heart broke for him. He went on to explain that the nurse had

taken care of his wife in her final moments a few months prior and he wanted her to care for him

in his time of need as well. He told me that he would be able to get a prescription for morphine if

he went on hospice and that she would help him when he was ready. He didn’t explicitly say

what his plan was, but there was no need. It was obvious as he spoke that he was ready to die.

He continued to tell me about how he was tired and that he didn’t want to be here

anymore. He spoke of physical pain and the emotional toll that he had suffered when his wife

passed. I told him that I heard him and that we would take care of him. I captured his vitals and

excused myself from the room to notify my provider. I told him about the conversation I had had

and he acknowledged that it was a difficult situation. You see, this patient is not sickly. He is

vibrant and full of life. He spent his life being a teacher and giving back to his community. I

could spend hours listening to him tell the story of his life.

Ultimately, my provider had a very lengthy conversation with him and spoke with his

children and the hospice nurse. This patient needs support and people who care to look out for

him. It is completely understandable that he would see this cancer diagnosis as a way out, but we

aren’t going to let him go so easily. Following his visit, I felt heavy and near tears. To see the

suffering and hurt in his eyes, there’s no words. I had never seen someone so ready to die.

The next patient I saw was one of our regulars that I’ve built yet another good

relationship with and we joke and laugh like old friends. It’s the following patient that left

another mark on me that day. A few months ago, we had a lot of contact from this patient as he

worked to navigate his wife’s pancreatic cancer diagnosis. She was also a patient in our office

and we cared for her until the day that she went on hospice and passed days later. This was the
first time would be seeing her husband since her passing and I wasn’t sure what to expect from

the interaction.

On the surface, he seemed like himself. He had put on some weight since we had last

seen him, which was great. He went on to say that he had been 145 pounds up until recently

when he began eating regularly again. I tried to keep the conversation light, but it ended up

drifting to the topic of his wife. I could tell that he needed to talk and that he had been through

hell. He told me about the night that she passed and how he considered taking her morphine and

fentanyl. He chuckled as he said that what stopped him was his fear of hospice getting there too

soon with Narcan before he was successful. Admittedly, when I had heard of her passing, I was

concerned about how he was going to handle it.

He talked about how he began drinking heavily as a way to cope and we laughed about

how that wasn’t an effective coping skill. We both knew that, but we also knew that was what

got him through the hard part. He continues to go through the things in the home that they shared

and he now wears her ring around his neck. He made it through, but I worry about how long he’ll

continue to push on.

It’s not often that I have days as heavy as the one I just described, but they hit hard when

they do happen. It’s moments like the ones that I just described that have called me to behavioral

health. So many people have battles that they fight behind closed doors and I want to be the

strength they can lean on when they feel like they can go no further.

Behavioral health exhibits the importance of the Catholic Social Teachings and the

message that lives in those word. Dignity of all humans is the one that comes to my mind most

when I think about the events of that day. The first patient that I talked about wants to die with
dignity on his own terms. I realize that any form of suicide does not align with the beliefs of the

Church, but as he sat there, I began to understand how important that choice is for some people.

As he put it, he isn’t living anymore, he’s existing.

Incredibly, my day concluded on a much lighter note. My last patient was being seen for

upper respiratory symptoms. She said that she had been putting off her own care to take care of

her grandchildren. She said that her daughter had given birth to another grandbaby on June 8th

and that her world had been a mess since. She told me about how her daughter became septic

days after getting home from the hospital and ended up being transferred to two separate

hospitals and undergoing brain surgery. It’s an amazing story. She said that all her daughter’s

doctors didn’t think she would survive.

The patient continued to share her story and excitedly got out her phone to show me

pictures of her daughter’s progress. It was incredible. She showed me her daughter intubated

following her brain surgery and then weeks later smiling with her children in her arms. There is

nothing to call that other than a miracle. She apologized for taking up so much time and I told

her don’t worry about it, I needed some joy after the day I had had.

I don’t think I’ve ever had a day that was so full spectrum in my career in the medical

field. I experienced sadness and overwhelming joy within hours and it was an amazing

experience. It’s important to maintain professional relationships with the patients and clients that

we encounter, but we’re still human, too, and it’s okay for us to feel for the people who trust us

to care for them.