Learning to say , “I’m Sorry.”

As we get closer to departing the U.S., I have been reflecting on our life here in Newberry. I realize that this community and the people in it have influenced us in many positive ways. I am going to start posting some occassional essays on the how Newberry has impacted our lives. I will entitle the series "From Newberry to Nairobi". I hope you will enjoy these. My first essay is titled "Learning to say, 'I'm Sorry.'" Enjoy!

++++++

As I sat at my desk getting ready to start seeing patients on a busy Friday afternoon, one of my employees knocked on my door, motioning that she needed to tell me something privately. “Dr. Hutchison, I don’t know how to say this, but Mrs. Smith, well, um, she says she doesn’t like you, and, well, she wants another doctor to take care of Mr. Smith.” As she said this the words exploded in my ears like fireworks. On top of the line of patients for this afternoon, I now had a disgruntled patient who needed my attention.

However, instead of raising a shield of defense, I asked Cathy to explain the situation. As she related the message her husband, Mrs. Smith’s pastor, shared with her over lunch, I began to review my interactions with Mrs. Smith over the past couple of weeks. Mr. Smith was dying. The night before I had admitted him to the hospital from the nursing home for the third time in 3 weeks. In fact, until 2 weeks ago, he had been the patient of an Internist for the past twenty years. But his declining health necessitated a nursing home admission. As the Internist did not admit to the nursing home, our practice was asked to accept him at the nursing home which one of my other partners did last week. But unfortunately, a flare up of Mr. Smith’s emphysema required readmission to the hospital last weekend. As the physician on call for the practice, I met Mr. And Mrs. Smith for the first time last week. At that time, I tried to reassure Mrs. Smith that despite the fact that I was the third physician to see Mr. Smith that week, I had indeed reviewed his chart to be able to provide good care for him during the hospitalization.

As I reviewed his chart, I learned that he was 92 years old and had a long history of chronic medical problems including COPD, CHF, Depression, Hypertension, and Dementia – all of which he was taking several medicines for.

I also learned that despite his poor health he had been cared for at home by his wife of 65 years until a year ago, when she broke her hip. According to the Internist who had cared for the patient all these past years, “If it weren’t for Mrs. Smith, Mr. Smith would have died 4-5 years ago.” Amazingly I also learned that Mrs. Smith recovered within 6-8 weeks after her hip fracture and was able to continue to care for Mr. Smith at an assisted living apartment here in town. It was obvious that her care and resolve had been more therapeutic the past couple of years than any of the medical interventions Mr. Smith had received. Unfortunately, even her resolve was not enough to restore Mr. Smith to better health now. However, Mr. Smith seemed to improve enough that after his weekend stay in the hospital, we transferred him back to the nursing home.

But time was running out. I received a phone call from the nursing home that Mr. Smith was now unresponsive and breathing fast. Despite the fact that we were not to resuscitate Mr. Smith, his wife asked that he be sent to the hospital. Realizing that the end was near, I bypassed the emergency department and sent Mr. Smith straight to the floor for his medical management. When doing rounds the next morning, Mr. Smith was unresponsive and Mrs. Smith was quite despondent. In fact, her pastor was in the room praying with the Smith’s when I entered. After a brief assessment of Mr. Smith, I told Mrs. Smith that things looked bad and that we probably should consult Hospice to coordinate comfort care. Mrs. Smith became silent and walked out of the room. Being in somewhat of a hurry I also left the room to finish rounds.

As Cathy finished telling me the situation and concerns of Mrs. Smith, she concluded by saying, “Dr. Hutchison, I know you care about people, so this must be just some misunderstanding.” I politely nodded and assured Cathy that I would visit Mrs. Smith this evening and try to correct the situation. As Cathy left, I realized that it was a misunderstanding, and it was my fault. I had not spent enough time with Mrs. Smith this morning and I had been too blunt. Even though my words said, “I’m not giving up on Mr. Smith”, my body language did. I had tried to avoid the time consuming task of providing comfort in a difficult and bleak situation. Mr. Smith was dying and I couldn’t help that, but Mrs. Smith was hurting and I could have helped that and I didn’t. Without being defensive, I realized I had but one option; I must apologize and ask Mrs. Smith to forgive me.

Later in the evening, as I made my way to Mr. Smith’s room, I noticed a small commotion from his room. A family friend was leaving the room in a hurry. As I entered the room, I found frail Mrs. Smith leaning over the rail gently kissing Mr. Smith on the forehead. As she looked up, with tears in her eyes, she whispered, “He’s gone. He’s gone.” I pulled my stethoscope from my pocket, and began to examine him. I looked up and reaffirmed her greatest fear; Mr. Smith had died. Mrs. Smith then began to explain his last moments as she again reached her thin bony hands and caressed her lifeless husband. I stood there silent, taking in the sweetness of 65 years of faithful devotion. After allowing her to grieve over her husband, I came along side of Mrs. Smith grabbed her hand and said I was sorry. Sorry for her loss, and sorry that I had caused her unnecessary stress by appearing too busy to listen. She graciously accepted my apology and I gave her a much needed hug.

Soon after Mr. Smith’s death, I learned that my apology had meant so much to Mrs. Smith. Cathy reported to me that I had “really won Mrs. Smith over.” But as I reflected on the whole scenario, I realized that it was Mrs. Smith who won me over. She taught me the importance of looking at the whole picture before deciding what needed to be done; her husband didn’t need hospice, he was going to die soon anyway. What was needed was a little time and empathy that Mrs. Smith was losing her husband. I also learned the extreme importance of apologizing for my thoughtlessness and hurry. If I had defended my actions from earlier in the day, I would not have stopped by Mr. Smith’s room later that day. But by willingly going to apologize, I was there in Mrs. Smith’s deepest time of need; the moment her husband passed away. I learned that despite conventional wisdom I can build a patient’s trust by learning to say, “I’m sorry.”

Comments

[Sharon]

Hi.. My name is Sharon I found your blog through someone who links to yours named Reid!! I love reading about those who love the Lord and those whose lives are dedicated to the Lord..
I enjoyed reading this post.. and your story reminded me of a time when a Doctor I had dealings with... did not apologise ... but God used him to help me because of his humaness!!
I have written a whole book on the web about when we lost a baby and you can find the paragraph ab out my dealings with a Doctor at this address..
http://my.homewithgod.com/tyler/Chapter7.htm
Paragraph 3..
The paragraph isn't very long.. but I understand you are a busy man.. so just thought I would share if you were interested!!
All the best for your going back to Nairobi.. May God bless you.. I hope to come back again and read some more on your life!!

[Sharon]

Hi.. My name is Sharon I found your blog through someone who links to yours named Reid!! I love reading about those who love the Lord and those whose lives are dedicated to the Lord..
I enjoyed reading this post.. and your story reminded me of a time when a Doctor I had dealings with... did not apologise ... but God used him to help me because of his humaness!!
I have written a whole book on the web about when we lost a baby and you can find the paragraph about my dealings with a Doctor at this address..
http://my.homewithgod.com/tyler/Chapter7.htm
Paragraph 3..
The paragraph isn't very long.. but I understand you are a busy man.. so just thought I would share if you were interested!!
All the best for your going back to Nairobi.. May God bless you.. I hope to come back again and read some more on your life!!