Trading places: When clinicians become patients
Lessons learned when clinicians find themselves as patients
By Sylvia Wrobel | Emory Health | Sep. 24, 2012
When he was alone in an Orlando hotel room, a piece of atherosclerotic plaque broke free in Lucky Jain's blood vessel, perhaps while he slept or dressed. As he strode to the conference room where he was to give the opening lecture of the annual neonatology board review, a clot began to form. It traveled silently, painlessly, toward his heart. When he climbed to the podium to address his colleagues, as he had done for 20 years, the clot suddenly and without warning blocked his left anterior descending artery. He waswaving to a former resident when he fell wordlessly to the floor, pale, without a pulse, not breathing.
A videographer instinctively yelled, "Is there a doctor in the house?" momentarily forgetting the hundreds already moving toward Jain. Chest compressions brought him back, at least part of the way. He remembers the EMT's standard question, "What's your name, doc? What's your name?" And he remembers the smile he got when he whispered a response.
Lucky. Only one in 20 people survive such severe cardiac arrest. Of those who do, many suffer irreversible brain damage. Time is key. An hour after Jain's collapse, Emory-trained Mark Steiner, director of cardiology at a nearby hospital, had removed the clot and put in a stent, restoring blood supply to Jain's heart and brain.
Jain—Richard W. Blumberg Professor of Pediatrics and one of Emory's busiest neonatologists—had become a patient. Physically fit, a serious tennis player still at his college weight, he hadn't seen it coming despite a family history of heart disease.
The first week was touch and go. A ventricular-assist device kept Jain's heart pumping. Back home, under the care of Emory colleagues led by Douglas Morris, he wore a defibrillator, ready to shock his sluggish heart back into action if it stopped. He spent three months in the cardiac rehabilitation program.
Did the patient experience change him? You bet, he says.
On a personal level, he slowed down to a somewhat less superhuman pace. "I had done so many things on the assumption that only I could do them," he says, "but when I looked around, I saw talent everywhere." He delegated more. He began to meditate. Instead of eating on the run, he now savors each bite. He spends more time with those he loves. He smiles more, says thank you more often, hugs more people.
And as a clinician, he emphasizes the personal, emotional, and spiritual aspects of patient care more.
Jain's wife Shabnam, an Emory pediatric emergency medicine physician, had refused to leave her husband's side while he was a patient in the ICU. His awareness of her presence gave him a new appreciation of the role that families play in "keeping their loved ones going." And not just families. Jain still tears up when speaking of the strength he gained from the concern of friends and colleagues.
Like most clinicians, he always had been careful to be as honest as possible when discussing possible outcomes. Now, having been at the opposite end of those difficult discussions, he tries to "keep the door of hope open" as wide as possible.
In Orlando, a young nurse gave him a small stone statue of an angel, promising to pray for him. Not a formally religious man, Jain nonetheless clung to the angel for days. He now encourages patients and families to draw on any available spiritual resources, without too much concern for what they are, "since they all lead to the same Almighty and all provide strength," he says.
And finally, Jain says that his faith in the U.S. health system, already high, went up many notches in light of his recent experience. "I am so proud of what we have here," he says. "If one of the conference center waiters had collapsed instead of me, the response of the physicians, EMT, ambulances, the hospital, would have been the same."