Brad was different after he returned from the warzone, having completed the second deployment of a stem cell transplant to combat multiple myeloma. He looked good despite his generalized battle fatigue, carrying both the scars of a dialysis fistula on his left arm and a chemotherapy port under his chest wall. Brad had received support from his family during this time and a great hurrah from coworkers upon his triumphant return to the office. Nevertheless, he had become marginalized through feelings of no longer fitting into mainstream society. He had been through a disease process that few experience and many shun.
People are often called upon to serve their country or serve their God, but there is always a price to pay in being “out there.” During this process one can become separated from the herd. While Brad loves time spent with his family, he particularly loves spending time with others with whom he can truly relate. Prior to his multiple myeloma diagnosis, Brad attended spin classes three times a week. Now he faithfully uses this same time assisting in church functions that aid the poor and visits others who also sit in the same dialysis chair he used to occupy. Brad is living proof that anything is possible through faith.
Similar to Middle East deployment, treating multiple myeloma takes a leap of faith. Naturally, the uncertainty of what lies beyond the horizon and the possibility of not returning home is very frightening. Brad did not know much about his enemy [multiple myeloma] and quickly realized that the fight is rarely with one enemy at a time – multiple medical diagnoses typically gang up on patients. Brad had to contend with a heart blockage during his first deployment and a blood clot in his leg following the second. Nevertheless, Brad’s leap of faith became an opportunity to deepen his faith while exploring his spirit connection to others.
Through faith, we are called upon to love our enemy (disease). Brad took this to heart by reaching out to others engaged in a similar fight with cancer. He believes this to be the path to glorify God and express gratitude. Brad never imagined God having abused him through striking him with multiple myeloma. God was truly using him. Following this battle, Brad continues to walk in the light of having formed a partnership with multiple myeloma based upon mutual respect – respecting his enemy as his greatest ally in personal fulfillment. Through confronting his mortality, Brad has become an enlisted foot soldier in the spiritual conquest of making a difference in other’s lives.
Second deployments give soldiers the opportunity to brag and state, “Been there, done that.” Having raised two successful children, Brad can also proudly claim victory as a parent. Although he looks forward to becoming a grandfather someday, he is simply grateful for each and every day. He thrives in being a grandperson who has been blessed by God and called to help heal the sick on an extremely personal and profound level – similar to that of raising children. Brad’s bout with multiple myeloma has seemingly increased his strength as a great father and shining example of Our Father, Who art in heaven.
In many respects, Brad represents the many fathers who are marginalized and perceived as being the lesser of two parents through spending more time deployed than at home. There exists a childish misunderstanding that Dads are less concerned about the well-being and value of those dear to them. Sadly, respect is mostly paid to fathers in retrospect – similar to how homage is often paid to our troops. We may poignantly look for ways to make amends to our fathers through supporting our troops, while hailing the visionary crusade, #DadsLivesMatter. The Wounded Warrior Project provides one opportunity to celebrate dads and the more personal is Team Brad. Truthfully, #KidsLivesMatter to the extent that they honor their fathers’ deployment and service.
Ruth was a spry, but frail 98-year-old woman who was stiff and sore following the 6-hour drive from California to Arizona. She had suffered a recent wrist injury and was not recovering well after spending three weeks in a rehabilitation center. She was in the midst of upheaval and discontent – in the throes of relocated to an assisted-living residence closer to her son. The facility’s coordinator had begun to evaluate Ruth’s aptitude and appropriateness for assisted living, but thought it best to have Ruth seen in the emergency department.
Ruth was hungry, but did not wish to eat. She felt like her bowels needed to move, but did not wish to use the bedside commode. While still engaging, Ruth wished to be left alone. Ruth had explained that she used to be able to tell herself not to be sick, but her higher power seemed to be failing her now. When a patient feels abandoned by a higher power, what hope is there for patient satisfaction? When patients are uncertain of what is in their best interest, how can physicians succeed at meeting their expectations? Does it become the physician’s duty to tell Ruth that she is not doing well and further deflate her self-image?
The breakdown in patient satisfaction often occurs when physicians cannot view the situation from the patient’s perspective. When the ED staff does not see the emergency, misunderstandings and missed opportunities frequently happen. There is a propensity for ED personnel to become defensive and stand their ground regarding standards of care and appropriate patient conduct. The parental cry resounds: do things my way or else. Coercion and entitlement rarely lead to patient satisfaction.
Having the right to care for others is risky business – particularly when patients might be on the fence as to their desired care. Rather than healthcare personnel digging in their heels of righteousness, these types of situations often call for personnel to dig deeper into self-awareness and question, “What would Jesus do?” The healer of all healers would show compassion and treat people with kindness, similar to how those with special needs are treated. Ruth was in delicate position and needed to be treated with kid gloves rather than sterile gloves. Given her stage in life, there was little hope of making her situation better. Doing more would most likely worsen her state of mind and lessen her satisfaction.
As situations often spin out of control in the ED, physicians are often called upon to soften their tone and maintain professionalism without authoritarianism. Through reassuring patients that we are in this together rather than working in opposition, hope springs eternal regarding patient satisfaction. Ruth simply needed to be reminded that she had the inner strength to weather the storm front at the end of life and that there was nothing really wrong with her. Nevertheless, she remained indifferent to the whole life-and-death conundrum. While this might be the best anyone hopes for, Ruth’s ED experience remained less than satisfying.