The Power of Accompaniment

For the past week, I’d been seeing a teenage patient in the PICU who had been in car accident and seemed to be recovering. He was on a ventilator and unconscious but was improving each day. One morning, I reported to the PICU expecting to see him more responsive. Instead, the words out of the attending physician’s mouth sent a ribbon of shock rippling through my body: “We’re withdrawing support.”

My head swam with a rush of emotions. When I walked into the patient’s room on rounds, my heart thudded as I anticipated the distress and anguish of his family. However, the atmosphere was the opposite of what I had expected. The lights were dim, and the room was full of grandparents, aunts, uncles, and cousins, all joining hands around the patient’s bed. Silent tears glistened on everyone’s faces. The air was filled with a heavy sadness, but it was tinged with acceptance and peace. What struck me was the pattern of concentric circles in the room. The physicians, nurses, and social workers formed an outer ring. Grandparents, aunts, uncles, and cousins formed the next. Closest to the bed were the boy’s parents. And at the center of all of these circles was the patient. Amidst the quiet suffering, the family’s voices rose in song.

To be present with the patient and his family in that moment was surreal. So much energy was focused on one boy that it was nearly tangible. I could almost see the love pouring out of the hearts of each person, family and physicians alike, into the patient as he lay on his hospital bed. The doctors in the room didn’t interrupt with a clinical agenda, but remained silent, offering the powerful gift of accompaniment. My eyes traced the patient’s swoosh of blond hair, his hand clasped tightly in his mother’s, his chest rising and falling with each perfectly timed breath of the ventilator. Tubes protruding, monitors beeping, numbers flashing, tears falling, voices rising.

The physicians hadn’t said anything since we’d stepped into the room at the beginning of the song. They simply stood in solidarity, present with the family through their suffering. The value of presence in the role of a physician was clear to me in that moment. Even when no treatment options remain, when medicine no longer has the answers, a physician walks alongside her patients until the very end.

The attending opened up about losing his own child. He said that in his 40 years in medicine, he had never seen a family handle the death of a child with such grace and strength. The mother responded, “I can see in your eyes that you care. You’re doctors, but you’re also human.”

This experience was a window into the weighty responsibilities a healthcare professional shoulders when entering into the life of a suffering person. Being open and vulnerable with patients can help patients and families process death. Offering presence through the most difficult times is how physicians exemplify the power of accompaniment. It is helpful to remember this when carrying out clinical duties during challenging times—while we are doctors, we are also human.