Showing genuine warmth is a compassionate way to comfort our patients.
Connecting with Patients | August 25, 2022 | 3 min read
By Aidan Crowley, Medical Student, University of Pennsylvania
The wheels of the magazine cart squeaked as I pushed it down the freshly mopped hallway of the oncology floor. Glancing down at the list of patients, I tugged at the collar of my starched blue volunteer polo. I was on “Patient Comfort Rounds,” where my role was to offer presence and accompaniment by sitting with patients. This included listening to their life stories, learning about their hobbies and passions, bringing a cup of ice or a warm blanket, talking through their hopes and fears, and playing a round of cards or a board game.
After I saw each patient, I’d write a short note about our interaction. In our volunteer training, we were taught to jot down words and phrases like, “water,” “warm blanket,” “conversation,” “door closed,” “medical team in room,” “game,” or “nothing.” The patient lists were stored in the volunteer binder for record-keeping.
At first, this documentation felt innocuous to me. However, as time went on, I began to feel unsettled as I looked through the pages. The word “nothing” was written for patient after patient, a monotonous column in pencil forming down the typed sheet of paper. While it was true that most patients said, “I’m good, thanks,” or “I don’t need anything,” these encounters didn’t feel like “nothing” to me.
For example, when I asked one woman if there was anything I could get her, she burst into tears. “A young spirit,” she replied between sobs. I froze. After this interaction, I hesitated outside of her room as my pencil hovered over the line. I didn’t get her water or a warm blanket or the crossword. We didn’t play Monopoly or cards, and we didn’t have a conversation. Did I really do “nothing?” It didn’t feel that way. A woman had just cried to me. Her heart was open and vulnerable, and I was present in a moment of fear and pain. I didn’t take any action—I was merely present. Was “nothing” what I should document?
From that moment forward, I decided that I would never again write “nothing.” Even if just a few words were exchanged, crossing the threshold into the room—and the life—of a person who is suffering isn’t “nothing.” I changed my strategy to write “talked,” “waved,” or even “smiled.” Every interaction with a patient is more than “nothing,” as it can shape their mood and their healing trajectory, even if in seemingly minor ways. Remembering this as I entered each room shifted the way I viewed my time with patients, because every moment matters.
Three years later in my first year of medical school I was no longer on the oncology floor in South Bend, Indiana; I was in the ICU in Philadelphia, Pennsylvania. The stiff blue volunteer polo had been replaced with scrubs.
A familiar scene emerged. While shadowing the palliative care team, I stood in a circle with the attending, fellow, and the patient’s wife outside of his room. After updating the wife about her husband’s condition and checking in on his goals of care, the fellow wrapped up our conversation with the typical question: “Is there anything else we can do for you?” Challenging topics had been discussed and the wife’s eyes brimmed with tears. She hesitated.
In that short pause, I thought back to Patient Comfort Rounds, knowing that however we were about to interact with this woman in the next moment would carry weight. “There’s no such thing as doing nothing even if she says there’s “nothing” we can do for her,” I reminded myself.
“I’ll take a hug,” the wife blurted with a laugh through her tears. Smiles broke out across all of our faces. The fellow embraced the wife in a caring gesture and the tension melted out of the circle. This was a moment of true humanity and grace and the wife re-entered her husband’s room with a new reassurance in her step.
This moment affirmed for me that even a hug can be medicine. The role of a clinician goes beyond pills and procedures to include comfort and compassion. These skills are equally essential to the delivery of competent clinical care. When you find yourself thinking there’s “nothing” you can do for your patient, remind yourself that presence and accompaniment may offer more than you think.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.