RT Book, Section
A1 Zhukovsky, Donna S.
A1 Epner, Daniel E.
A2 Epner, Daniel E.
SR Print(0)
ID 1190085937
T1 Going the Extra Mile
T2 Empathy: Real Stories to Inspire and Enlighten Busy Clinicians
YR 2022
FD 2022
PB McGraw Hill LLC
PP New York, NY
SN 9781260473414
LK hemonc.mhmedical.com/content.aspx?aid=1190085937
RD 2024/04/24
AB A  PATIENT  I  cared  for  recently  reminded  me  that  actions  can  sometimes  be  more  empathic  than  the  most  empathic  words.  The  hospitalist  asked  me  to  see  a  man  in  the  ICU  with  progressive  refractory  lung  cancer  who  experienced  respiratory  failure  and  required  mechanical  ventilation.  Prior  to  intubation,  his  dying  wish  was  to  return  to  his  hometown,  a  4–5-hour  drive  from  our  hospital.  After  compassionate  extubation  by  the  ICU  team  the  day  before,  a  Sunday,  to  prepare  him  for  transition  to  hospice,  his  family  was  determined  to  get  him  back  home  no  matter  what.  When  I  arrived  on  the  scene  a  few  minutes  after  receiving  the  consultation  request,  the  man's  family  was  so  irate  that  they  literally  would  not  let  me  into  the  room  to  see  him.  Multiple  daughters  and  granddaughters,  some  of  whom  were  nurses  with  strong  opinions  about  his  care,  filled  the  hallway,  where  they  loudly  directed  a  barrage  of  grievances  toward  me,  barely  pausing  for  breath.  They  were  so  angry  and  frustrated  that  I  was  unable  to  get  meaningful  information  from  them,  so  I  stood  there  silently  and  allowed  them  to  vent  for  several  minutes.  They  eventually  calmed  down  enough  to  explain  thatthe  ICU  team  had  assured  them  that  they  could  make  the  trip  back  home  the  next  morning,  only  to  find  out  that  several  logistical  details  were  delaying  discharge  and  making  it  increasingly  likely  that  the  man  would  die  before  making  it  home.  To  compound  the  problem,  his  family  had  already  paid  several  thousand  dollars  for  a  ground  ambulance  that  was  non-refundable.  The  hospitalist  coming  on  service  that  day  asked  our  supportive  care  team  to  facilitate  transition  home  to  hospice  at  the  11th  hour,  even  though  we  had  never  met  the  patient  before.