I Didn’t Know it Was You

It was a sunny Saturday afternoon, and for the first time after my surgery for colon cancer I felt hopeful. The attending surgeon, who I knew as a colleague, said I was doing well and could go home the next day. I smiled and as soon as he left the room I called my husband with the good news.

While it was still dark on Sunday morning, a team of surgical residents, the ones who had stayed the night, rounded in my room. They went over my symptoms and labs—all fine. Still hazy from my fitful sleep, I didn’t think to ask questions— after all, the next shift of doctors would be handling my discharge.

After the sun rose, my new nurse came in and we talked about how excited I was to go home, be with my infant twins, sleep in my own bed, and eat homemade food. She paged the day team resident about my discharge. My husband came in to be with me. Together we waited. And waited. My nurse told me the resident had called back and said that I wasn’t going to be discharged. She didn’t know why. I asked if I could talk to him and she diligently paged him again.

Hours later he finally came. As the resident walked into the room he looked at me and his mouth dropped open.

“I didn’t know it was you,” he said with astonishment.

I stared at him. A transitional anesthesia resident, he had been my intern for two days on my internal medicine team a few months ago. Standing in front of me, he stumbled through a few questions about how I was feeling, asked me what the previous day’s attending had said, and told me he would work on my discharge after confirming with his attending.

I lay in my bed, astounded.  An hour later I was on my way home.

Years later this is still one of the defining moments I’ve had as a patient. Here are 3 things I took away from that experience:

1. Every patient is important.

I inferred from the resident’s words that if he had known that I, his former attending physician, was the patient, he would have come sooner. But every patient is someone’s mother, father, sibling, neighbor, or friend. Every patient deserves respect and a conversation with the medical team.

2. Communication between team members is key.

Formal handover processes are crucial as teams switch services. Not only important for residents from shift to shift, attendings should remember to sign out to their attending colleagues and review updates with their residents before the end of the shift so that everyone is on the same page.

3. Goals and expectations are essential for patients.

Talking about the expected course and discharge goals for a hospital stay is essential for safe and effective discharges. Using shared decision making around these goals can also balance the interests of the medical team with those of the patient.