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Teaching and Learning Moments

THANK YOU, MR. STEWART

HARRINGTON, JOHN W., MD

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Although I am a pediatrician, the greatest lesson of compassion that I learned was eleven years ago from a 65-year-old man named Mr. Stewart, who was losing his wife to metastatic breast cancer. I was a third-year medical student more concerned about trying to get honors in medicine and going to a prestigious pediatric residency program than to care about an elderly woman. Mr. Stewart held a vigil by his wife's bedside. His wife's cancer had progressed to the point where no conventional chemotherapy or radiation could help. She was on an experimental regimen that even her oncologist was skeptical about. Our medicine team would round on Mrs. Stewart every day. As we entered the room Mr. Stewart would rise and search our eyes for some glimmer of hope. I would ask the medical intern as we left the room, “what should we do today for Mrs. Stewart,” and he would always reply, “NTD.” This meant “nothing to do.” As Mrs. Stewart deteriorated and it was obvious the cancer had spread to her brain, our team would try to bypass entering her room. The stench from loss of bowel and bladder control would fill her room and permeate the hallway. Mr. Stewart would always be there, waiting for a hopeful word from the doctors. Since no one else was willing to enter this hopeless situation, I began making my own rounds to Mrs. Stewart's room and her husband decided I was his wife's real doctor. We spoke about his wife in the present tense; about her accomplishments as a dancer and singer. He confided in me that he was scared and was so afraid to be alone. He thought there was some chance that his wife might still pull through and didn't want to give up hope. At six in the morning after the only night that Mr. Stewart did not sleep over, his wife went into respiratory arrest. The intern on call had contacted Mr. Stewart, but he had refused to agree to a DNR until he spoke to the real doctor who has been caring for his wife. I was drawing blood from patients on the seventh floor and was summoned to the phone. Mr. Stewart asked me, “My wife is dying, what should I do, Dr. Harrington?” There was a long pause because I really did not know what to say. I simply said, “I know and I'm sorry. I'm here, what would you like me to do?” He said through tears, “Please don't let them hurt her, just make her comfortable.” I told him we would give her medicines for pain and I would stay with her until he came. I held his wife's hand and cried as if I had lost my own mother. To this day I have frequent contact with Mr. Stewart. He helps to remind me why I love being a physician.

© 2002 Association of American Medical Colleges