5 Things Doctors Wish You Knew (that will empower you)

By Phoebe Chi, MD

Have you ever left a doctor’s office somewhat disappointed with your visit? Maybe you just spoke to a physician, but instead of having all your concerns addressed, you find yourself with even more questions? Do you ever wonder what doctors secretly wished patients would do that would make caring for you a smoother process?

My purpose in writing this post is to do two things: to provide practical tips that you can use today that will 1) help prepare you for encounters you might have with the health care system in the future…whether it’s a routine doctor’s visit or an unexpected trip to the ER, and 2) help you make the most out of your interactions with your physicians.

Therefore, without further ado…

Continue reading “5 Things Doctors Wish You Knew (that will empower you)”

The Waning.

You already knew.
Gaze unflinching, 

you told us to say the words.

Amyotrophic lateral sclerosis

A. L. S.

Despite sparse questions,
your eyes revealed
an understanding far deeper
than our answers-

that with one moment,
robbed were you

of the years ahead,
of memories awaiting,
of stories belonging to you.
Now lost.

Strength dissolving,
your conviction remains
unscathed.

You savor
each passing sunrise.

Each caress, each step.
For you know.
As your legs cease to support,
arms stop to comply,
you still feel
your child’s touch.

Absorbing her love.
Pretending
you don’t care the roles
have been reversed

as you yearn
to return her embrace.

As its hunger ascends,
You treasure
the remaining days.

Every word, every smile.
For you know.
Soon it
consumes your voice,

drains your visage,
until all that is left is
the silence
of a vacant mask.

Unable to reflect
your thought’s grin,

your heart’s laugh,
your soul tears
as you blink away the moisture.

As your breaths
increasingly betray you,

you are not defeated,
for the flames
of your bruised spirit
are not quenched,

and you give thanks
for the time you had,

even as your body dims
and you fade away.

A Memory of Ground Beef.

Once when I was on a specialized heart failure service, I took care of a teenage boy. He had a form of idiopathic dilated cardiomyopathy (a weak, enlarged heart), and he had a huge heart…in more ways than one.

He loved baseball, pumpkin pie, and horses. His family owned a farm, so before he got sick, he would often go horseback riding. He also loved to draw.

We—a team of five physicians—took care of him for a month while he was waiting for a heart transplant. He liked us. We liked him. So he drew us as well.

I thought he was clever. But he thought I was even more so. All because he liked my joke:

“What do you call a cow with no legs?”

“Ground beef.”

That was it. He was just a great kid, trying his best to live the life given to him.

It used to be, that at the end of our visits, we would both say to each other, “Ground beef!” with a wink and a huge smile. It perplexed the other physicians, but we knew exactly what we were talking about.

It was just a silly joke. But for the two of us, it somehow meant something more. 

I found out recently that he passed away. And today I found the drawing he gave me. And I wept.

So here’s to you, dear buddy…

Ground beef 😉

Public Health & Turkey Fun.

• Santa Elena, Belize •

One of our tasks was to visit the residents in Western Belize. While our purpose was to conduct epidemiologic study and to raise disease awareness, it was just a pleasure getting to know the community.

Also, we made sure to always take time to admire the pet turkeys. 

😀

The Hug.

Bitterness.
Each word, a slap.
Each consonant, piercing.
Bursting in like a winter’s storm,
you permeated into our lives.

We wanted to help you,
but we only came to fear you.
Many shook their heads in pity.
Some avoided you.
Others talked about you.

Contempt.
Each gesture, scornful.
Each insult, stinging.
My attempts to talk to you
only seemed to anger you more.

You terrified me. Yet I yearned.
To see. To know. To understand.

I knew you were frustrated.
Your disease, unforgiving.
Slowly devouring. 
I knew you were discouraged.
Your body, powerless.
Slowly succumbing.

But why wouldn’t you let us care for you?

Desperation.
Each day, the same.
Each encounter, fruitless.
You turned us away again and again. 
Until one day I confronted you. 
I asked you why.
And you told me.

I know you don’t really care. This is only your job. 

My job.

It all made sense.
The bitterness. The coldness. The distancing.
I understood.

Stepping forward,
leaving behind the pride, the decorum, 
my arms enclosed around you.
The fear escaping my racing heart
only after you made a move to wipe your eyes.

You then collapsed into me.
My shoulder, an insulation
to the sound of choked sobs.

You never said a word.
But in your cry I heard your anguish.
I heard desolation.
I heard relief.

Things were never the same after that.

Your bitterness was gone.
Your words, softer.
Your eyes, warmer.
You allowed us to care for you, 
remaining strong even
as your disease progressed.

Until one day, like winter’s snow, 
the seasons beckoned for you to leave.
But even then, as you faded away,
you reminded me of the day everything changed–

The day I gave you the hug. 

The Patient.

I met you my intern year. I remember the first thing you said to me.

“I don’t care to be here.”

With a countenance creased from decades of hardship, a gait staggered from illness, eyes steeled by sufferings, your restrained presence betrayed a sheath impervious. I believed you previously had poor experiences in similar settings, because you told me so. I knew you didn’t trust me, because you told me so.

Our first few visits were stippled with formality. I posed questions; you answered. But they weren’t your answers, but perhaps words you knew I wanted to hear. I half expected you to stop coming. But you never did. Instead, you continued to sit there, guarded, a portrait of cordiality and cautiousness. 

And then one day it happened.

Your hard gaze glimmering with moisture, I saw your shell break. I then got to know you. Little by little, visit by visit. I learned of the pain you endure. I learned of your frustrations, your desperation…your despair. I learned of your deep heart. I learned many things. But most importantly, I learned who you were.

Months went by. Gradually a smile seeped through. Your eyes now shined as you shared with me the latest on your life. A life that I was lucky enough to now be a part of. But suddenly three years pass, and as my time with the clinic comes to an end, we now must part. On your last visit, I sense your frustration and anguish again, and I think I understand why. As you cry I reassure you that everything will be okay. But as I comfort you I am struck by a sudden surge of emotion, and I also struggle to keep my composure.

You see, through this experience, I have started to recognize what it is you were talking about. An understanding. A connection. Some may even say a friendship. Because even though you may not know this, I am now happier because you are happier. Because you are now healthier, more satisfied. Full of life. 

Now as we part I feel the tearing of a piece of my soul. As we hug one last time the goodbye is silent and understood. But then you pull back, look me in the eyes, and say simply, “Thank you for helping me live.”

As I hold back my own tears, I realize I am thinking the same thing.

Thank you for helping me live.

When We Simply Stop Caring.

I see it all around me.

Burnout. To be burnt.

When we simply stop caring.

Most of the time we don’t even need
to say anything.
But you know.
You hear it in our voice.
You see it in our eyes.
And you feel it too.
You know what
is going through our
mind with each wayward glance.

Is this what I signed up for?
Is this all this profession has to offer? 

Because I have seen the articles.
To prevent physician burnout.
The A-B-C’s.
Changes we must make.
Limiting expectations. 
Self-empowerment.
Decreased hours. 
Putting us first.

I too used to be desperate.

What is happening to me?
What is happening to my colleagues?

What is happening to medicine?

But then one day, I saw you.

You.

Not you the patient.
You the person.
You’re just
a person.
You are me.
And you are hurting.
And maybe I am too, although
you may never know.

So I thank you for being here.

Not only do I want you to know that
I honor the privilege of being able to
help you, but you should know that
you have in your own way
taken care of me.

And I do care for you.

◊ A Physician’s Plea ◊

To Let the Heart Speak.

Dear Diary,

What do I write about when I have nothing to write about?

When my lips have nothing to say?

Do I paint for you portraits
of hollow chimes adrift
in dew whose songs
mesmerize with
each sway of
the wind’s
caress?

Do I liken you to a single rose
who has but endured a
winter’s wrath to
weave a quilt
of fragrant
hues?

Or do I reflect upon my life as it is,
to tell you how much I treasure
the privilege of being able to
help you, to care for
you, whenever
you are
ill?

Do I try to express how tremendous my
heart feels when I tell you that it is
going to be alright, or when we

know that it may not, that
we will 
conquer it

together?

Do I admit to you that whenever you
smile, my day is brightened,
my heart is warmed,
and that when you
weep, my soul
tears with
you?

And do I tell you how much I appreciate you-
your presence, your courage- as you
battle through your illnesses,
uncertainties, and fears-
while reminding you
that you are an
inspiration
to me?

So what do I do when my lips can find no words?

I suppose I let the heart speak.

I’m Sorry I Couldn’t Do More.

You took your life.

I’m sorry I was only
fifteen feet away.

The doctors were only fifteen feet away.

You didn’t know this.
But I spent days and nights
next door to where you decided
to end your life. Where the doctors
gather, pondering over differentials…
treatments…dissecting our every move
to ensure that we are doing the
right thing for you.

The right thing…

If I had known you,
I would have fought for you.
I know you weren’t my patient;
I know we had never even met.
I am just the person who found
you. Who pronounced you.
You were already cold,
but still, I placed the
stethoscope against
your chest and
listened.

I didn’t hear anything.

Did you hear me as
I wept for you?

I’m sorry.

I’m sorry
you were suffering.

I’m sorry you felt
as if
you had
no way out.

I’m sorry I couldn’t do more. 

This is a reflection over an event that happened during residency.
An event I still think about at times. 
A lingering guilt.

Hope.

“My life laid before me… my treasons my troth
Wrapped with transcendence in fine sacred cloth
My breath must surrender to cold mortal brew
As wildflowers bend neath pure morning dew.

And then there were angels
Filling the sky
Lifting me upward…

And then I could fly.

These are the words of a fellow blogger and poet.
Words that affect me more than one can know.
So I would like to use this post to thank him today
for being a glimmer in the night…and an inspirer of hope.

Because in our own way, we are all physicians.

He is Steven Michael Sanders,
‘Michael33’

I am asking you to visit him, 
because his poetry will enliven you,
and his story will inspire you.

♣ The Vision of Poets – His poetry blog ♣

♣ Vision of Hope 33 – A blog of his journey ♣

With Love, 

PuppyDoc

The Flawed Physician.

She stands facing a closed door.

Your door.

As her gaze converges onto
enameled surface, she notes its
texture- the evenness a comfort to
a moment of hesitation within.

Smooth and finished–flowing
imprints mapping the course of
fine fibers swept over timber.

Flawless.

She makes a move to knock,
but her hand pauses,
and for a moment she wonders
whether you will find her pleasant.

Whether she will be worthy of your trust.
Whether you will believe in her.

Because she is flawed.

Like veneer upon wooden door, she
is but a polished version of herself.

As she again surveys its exterior,
she is let in upon a different truth–
that from underneath the surface
the grain peeks through, coarse
and jagged, its valleys exposed,
blemish revealed, age betrayed.
It is but fresh lacquer upon a
damaged interior, eroded and
frayed by the stress of time.

Like a white coat to the skin,
it cloaks the imperfection
and vulnerability of that
which lies beneath.

A coat enshrouding
scars of personal defeats–
An awareness
of critical introspection while
striving to exhibit confidence and certainty.
A struggle
to remain objective while
craving to empathize with you.
A hunger
to continue feeling through perpetual
immersion into death and suffering,
while self-preservation casts increasingly

impenetrable layers of emotional shield.
And a fear
of not doing enough, while similarly
recognizing the peril of doing too much.

But as her knuckles meet the door,
she is reminded of an oath–taken
at the dawn of this journey–
an oath of compassion, of
integrity, of humility–

an oath to do no harm.

So as she enters
your room,

she smiles–
for she never forgot its
concluding admonition:

That one would never lose the joy of helping others.

Therefore as an imperfect human being,
she will do her best to ease your suffering,
treat your illness, be your advocate–
Not because it is her obligation,
but because this is her love–

To help her fellow man.

To care for you.

•      •      •

“…may I long experience the joy of healing those who seek my help.”

-Oath of Hippocrates

•      •      •

caduceus

I.C.U.

Lines, tubes, wires, chains.
Dignity stripped, cavities drained.
The metronome of your pulse above
the beeping orchestra, dissonant buzz.
Each gesture tracked, beat recorded,
breathing measured, life distorted.
Do you still feel free?

The body, its function a masterpiece to muse,
altered by poison, fluid infused.
Vesicles, vessels, organs affixed,
shrouded in blood, lymph intermixed.
Adhered in oneness by tendon and skin,
scarcely quickened by a pump grown dim.
Do you still feel strong?

Risen before the dawning sun,
a swarm of stoic white has come
to declare the status of your issues–
Liver, kidney, heart, lung, tissue.
To examine and prod, inspect then move
a person, a soul, or a number to improve?
I hope you still feel human.

A PuppyDoc’s Return.

To that hiatus sweet,
she bids farewell
to rise to her feet
and don her white tail.

For truly did she miss each one of you,
C-dog, Amity…ol’ Noodle too.
Randoms by a Random, WritersDream,
OneSpoiledBacon— uh…Cat, I mean!

To all others I have failed to name,
forgive me, for I am truly to blame.
As I am merely, sadly, only a doc–
a doc who can’t rhyme but thinks she’s a pup.
Pup. Cup. Rupp. Knupp.

Oh dear, now I’ve run amok.

What I meant to say, but failed to do, is…

Happy Holidays to all of you!

The Arrest.

A code called.
She races
as the seas part
for her crossing.

Reposed before her–
rhythm without pulse,
fluid without flow,

substance without life–
is you.

Invaded
as lines in your thigh

penetrate a pump paralyzed,
as tube between ashen lips
thrusts into stagnant air.
Poison pushed into a heart
quivering, she watches as

your chest rises
with the force

of each counterfeit breath.

The symphony begins.

Thump
Shock delivered.
Strike through the breast.
Voltage down your limbs.
Buoyant, jerking,
Each retort
a life feigned by lightening.

Crunch
Bones crush.
The carol of ribs,
a surrender to the fury
of each compression,

quickens with her pounding heart.
Each chord
a dissonant harmony.

Glazed are your eyes
as they pulsate
with the cadence of their dance.
She looks at you.
Pleads for you to return.
Prays to the god she plays.
But your eyes plead for something more.

You leave her.

The story ends.

And the orchestra leaves.

•      •      •

◊ The Cardiac Arrest From a Patient’s Perspective ◊

•      •      •

The arrest

The Big Heart.

Fluid.
Limbs flooded,
lungs immersed,
skin engorged-
you chase it off.
Pill
after pill.

Nights.
Twilight wheezes 

upon three pillows.
Four.
Five.

Bare
are your breaths
as you gasp,
fight-
hunger unquenched.

Stairs
unconquerable,
indomitable,
fatigue intractable.
Slowly you ascend.

Still
you conquer,
embrace
love,

life,
strength.

Your heart full.

Your dilated cardiomyopathy.

 

Cadaver.

Tendons, vessels, muscle, bone-
little more than its sum, alone.
Without life, alone.

A heart upon your fingers,
fibers smooth, firmness lingers.
A pump sleeps, alone.

Nerves, severed and denuded,
shimmering, taut, function diluted.
Pain without feeling, alone.

A lung, delicate sponge, blackened,
absorbs an essence, greyed, maddened.
Vacant sacs, stale breaths, alone.

The cerebrum, split, its valleys and mounds,
embodies a soul, full, without bounds.
My lifeless being is nothing alone.

Our New Year Promises to You.

 

puppydoc

PuppyDoc’s list

In the new year, I will…

1. …try to help a homeless person in some way each day.
2. …h
ug more elderly patients.
3. …remind
each nurse I see that he/she is appreciated.
4. …f
all in love with medicine all over again,
5. …and hopefully i
nspire someone else to as well.

At the same time, I will try not to neglect my own well-being by…

6. …listening to my mom about eating more veggies,
7.
…not avoiding the dentist,
8. …realizing that a Clif Bar plus a Red Bull doesn’t constitute an ideal meal,

9. …and not refusing to go to the doctor… 

But seriously…

10. I only hope to make a small difference…one day at a time (…and live happily ever after with Samantha, of course).

 

 

Samantha

Samantha’s list

Upon the next moon, I shall…

1. …find more ways to earn treats…
2. …but at the same time lose 3 lbs.

3. …
stop stealing pepperoni off my human’s pizza,
4. …
stop stealing chicken wings off the kitchen counter,
5. …and
try not to take up the entire pillow when sleeping atop my human’s head at night.

Moreover, if I find a gecko, or any living creature smaller than me, I shall…

6. …not bite it,
7. …nor squish it,
8. …nor terrify it with my intimidating presence,
9. …but allow it to go on living its peaceful life.

But most importantly…

10. I will remain fluffy, loving, and sweet…and live happily ever after with my human.

 

 

 

The Story of PuppyDoc.

Once upon a time in a land far away (ie., Taiwan), there existed a smallish girl named Phoebe…

 phoebe chi

…who, in the 1980’s, was born into a family…complete with a mom, a dad, and a pet gibbon.

gibbon.jpg

From an early age, Phoebe adored animals, therefore, when she grew up and went to university, she decided to become a purple kangaroo for the patients at the children’s hospital.

 kangaroo

Phoebe soon realized something: she loved to help people. Eventually, this realization led her to start traveling the world, for long periods of time, to do volunteer work.

Of all the places, Phoebe worked in Africa the longest…namely, in the lands of West Africa and Madagascar.

On the island of Madagascar, Phoebe was known for befriending a lonely stray lemur named Buddy…

 lemur

…with whom she would share her cactus fruit every morning.

There, she lived in a small village with a sweet family of 20 vibrant sisters…all of whom liked to dance.

Phoebe Chi Madagascar

On the other side of the continent, in the land of Ghana, she also lived with a lovely family, but in lieu of a lemur, she had a goat friend (who, tragically, eventually got eaten…).

goat

After all that, Phoebe returned to the U.S. and became a doctor, because more than anything…she still wanted to help people.

thankyou.jpg

Now, during her journey through medical school, her peers started to call her ‘Puppy,’ primarily, they claimed, because of her “loyal, affectionate, and loving nature.”

Gradually, the name ‘Puppy’ evolved until, finally, one day…

Phoebe Chi

…a ‘PuppyDoc‘ was born.

The End.

 

 

The Sleep.

Rivulets of sorrow meandering
down
tear-stained skin.
“Keep her comfortable
until it’s time.”   
Simple words-
echoes
of eternal reminder within.
You rise.

Guiding her
through the threshold
into the chill,

shudders
of realization emerge.

You survey
the molting trees,

their arid leaves
embellishing her hair
like fragments of
woven rhinestones.
As if they weep for her.
As if even the ambiances
of ages past are beseeching
her not to leave.

Soon arrives the Foehn,
holding you within
its warm embrace.
Its breaths,
whispering lines of truth,
sculpt a bittersweet tune
as they herald
the evening’s arrival.
You understand.

Cloaked
by lyrics of singing ivy,
her expression calms,
your fears dissolve.
Consoled by a draft possessive,
you cradle her
through the darkness
and follow her
toward the seraph’s call
into the fold of
midnight slumber.

The Tragedy Behind a Poem.

We did it. We took it out.

Slowly, the oxygen saturation dropped.
Gradually, the alarms sounded.
Insisting. Imploring us to do something.
We turned them off.
Made him comfortable.
But we knew we couldn’t hide the truth.

We were letting him suffocate.

~     ~     ~

A lucid man.
A failing lung. A decision made.
A breathing tube placed—just temporarily—
until the lungs healed.
Until they got stronger. Until he got stronger.
But I saw the regret the moment it was inserted.
Nevertheless. We agreed to give it a chance.

But days passed. Then weeks.
No improvement.
Being alert, he communicated with us well.
Through his writing, I got to know him well.
His adventures. His best memory. His regrets in life.
He was a good man.

But a man who never desired to live like this.

While the family disputed on what course of action to take next,
he remained calm and unwavering.

“Please let me go.” was what he would say.

Then finally the moment came.

The time to say goodbye.

~     ~     ~

That day, I let myself weep during rounds.
In front of a crowd of stoic faces.
To weep over a friend.
To weep over a human being.
Over his courage.
An impossible decision.
The loss of a life.
Everything.

Because I didn’t want to do it. But I did.

I let go.

•      •      •

“To Let Go” – the poem

To Kaitlyn, a Girl I Will Never Know.

I’ve been wanting to write this to you for a while. I go to work, and though I’ve never met you, I think about you. I talk to a patient, and while I’m standing there, there you are again, tugging at my heart. Maybe it’s because I know of your mom, and I know of her heartbreak. Maybe it’s because I know you will never be able to do what you were meant to do.

This is what I know about you. You were a medical student. You went to school in North Carolina. You cared for people. And you wanted to care for them at the greatest capacity possible. You wanted to help people during their times of sickness, strengthen them in their weakness. But your life was robbed from beneath you. So this will never happen. And the world has lost another great physician.

I hear you were a loving person, one who illuminated the day of all whom you came across. Of course you did. You were your mother’s shining star. But what no one knew, and what you didn’t reveal until your departure, was that you were also suffering. Deeply. But you were good at hiding it with your smile. And because it was a genuine smile, we were beguiled. Especially those closest to you.

bench

When I think of you, my heart aches. Maybe it’s because I feel that I understand you better than I have a right to. Maybe it is because I once smiled a similar smile. I weep because of what you did, and because I think I understand why.

When I think of you, my soul is anguished. You were going to be a remarkable physician. You would have touched others with your empathy, changed lives with your care. They would have remembered you, not simply because you were the one who eased their suffering and comforted their souls, but because your spirit would have brightened their lives. No one had the right to take that away from you.

I’m sorry I never got to know you.

But even now, you will not be forgotten.

◊ A Tribute to her Mother: Rhonda Elkins ◊

◊ A Poem Dedicated to Kaitlyn and her Mother ◊

Some people call this a hospital.
I like to call this a place of my P’s.
A hidden treasure
in a downtown peach orchard

where all my P’s roam.
But don’t panic.
Let’s pause.

This is the place
where physicians palpate,
pain is palliated,
and papillae are poked.

Patients are pacified,
parking is pitiful,
penlights are peddled,
and parolees panto.

But me?
I just call this home.

 

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