Hovering
What do I so fear hovering outside these sliding doors? I peek in at the ventilator, the patient’s mother, Kumiko, sitting at her side. We pretend not to see one another. I pretend to look down at my stack of papers filled with barely legible vital signs, labs, and other numerical parameters. And then I walk away.
What do I fear? Will the patient suddenly rise out of her paralyzed state and seize me? Will Kumiko ask me questions with those deep wells in her eyes? I cannot bear that. Will rounds go past noon again? The attending will not bear that.
Andrew Kim, MD, MPhil
I’ll swing by after rounds, I assure myself, hoping that Kumiko can hear my thoughts and justifying to myself that I really care. But the uncomfortable reality is that my pager will dependably beep its cheerful ‘giddyup’ tone in the afternoon, and I will have another reason to walk by room 14 with uneasy, averted eyes.
What do I so fear in facing Kumiko’s humanity? The patient’s humanity? My humanity?
Will I say something awkward when Kumiko asks for compassion? Or worse, something canned, learned from “Professional Development I” in my medical school auditorium with patient actors. That mechanical dance of hand-on-lap, tissue-offered, and somber, “I’m so sorry. This must be hard for you.” I hate it when I do that. The stripping of my reality.
Or do I fear that I can no longer handle the realness of this situation? Have I stacked up so many unprocessed deaths and such weight of grief that if I really, for once, faced the true depth held in room 14, it might break me? I hate crying, especially in front of other people. The fracture of my image as the equanimous physician.
A friend and colleague recently reminded me that when I was his intern, I sat with a dying patient for four hours until a “No One Dies Alone” volunteer could come in for the evening. I can’t believe it anymore. How did I sit there for four hours, notes undone, not checking my phone once, just sitting there listening to YouTube’s classical music station, watching the light change over the Golden Gate Bridge? I hate to acknowledge that medical training has changed me, to acknowledge the loss of my capacity for presence.
At 2:30 p.m., the nurse pages me, “Patient’s mom leaving in 20 min. Would like updates. Can call her later at home if you can’t get to it before.” Now, I fear the nurse and Kumiko will think, “This doctor is finally coming to give updates. We’ve only had to wait five hours.”
Finally, I walk into those sliding doors. Kumiko stands up, smiles, and says, “Hi, Dr. Kim,” in a tone that betrays no impatience, no judgment, no anger. Only a genuine hello.
I start with an apology, “I’m so sorry it’s taken so long for me to come by…” Before I can give a half-hearted rationalization, she says, “It’s okay. Thank you for coming.” Her tone is genuine. We finally sit. We talk about Okinawa. We talk about the patient’s… no, Miya’s favorite tunes, the transition to San Francisco, the last time they went back to the island. We talk about nothing. We let the sounds of the sanshin from portable speakers waft above us as we sit without words, our hands together on Miya’s unmoving left shoulder. I lift momentarily out of this eternal presence to ask if she has any medical questions, breaking the trance. She looks at me kindly, patiently, shakes her head no, and pulls me back into the moment. It doesn’t last long. Maybe eighteen minutes. And then she goes home.
For those eighteen minutes, Kumiko reminded me how we might embrace the imminent depths of our humanity. That we could, without words, stop our skirting across the superficiality of life and tap into something greater than ourselves—vaster than the tragedy of a prolonged death in the hospital—into the incomprehensible depths of this present moment. We only need to allow ourselves to be engulfed.
These are rare moments when I free myself from the never-ending drive for efficiency in modern medicine and instead heed the counsel of Elie Wiesel, author and Nobel laureate:
“We must not see any person as an abstraction. Instead, we must see in every person a universe with its own secrets, with its own treasures, with its own sources of anguish, and with some measure of triumph.”
When I finally allow these moments to sink in, my hovering body can finally land on the ground of this very moment.