Medical practice

How my forever moments have shaped me as a doctor

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By Nathan Merriman

Each of us collects what I call forever moments, whether we’re aware of them or not. These emotionally charged personal and professional moments become strongly embedded into our long-term memories and can indefinitely affect our behaviors, values, and perspectives.

My first forever moment came at age 13, when my 11-year-old brother and I survived a house fire that killed our parents. It wasn’t actually a single event but a series of powerful moments that created an enduring impression: my abrupt awakening to thick, grey smoke in my bedroom; the crash of splintered wood on my outstretched hand as my neighbor kicked in our front door; the unimaginable words from my uncle as he told my brother and me that our parents had died during the fire; and the comforting blanket placed over my shoulders by the emergency medical technician in the back of the ambulance on my way to the hospital. I’ve had other forever moments since then — as a parent, a patient, and a physician — that have shaped my life and my work as a physician.

Health care is filled with forever moments for patients and their family members, who often feel vulnerable and isolated during these stressful experiences. One of the many important jobs of health care providers is to help patients and families through these times by being sensitive to and supportive of what they are going through.

Some forever moments are easy to spot. Others aren’t. Complicating matters further is that time with patients is often dominated by digital distractions and measured productivity pressures. These can get in the way of the personal connection that is so essential to seeing another individual’s forever moment. One way to more easily connect with patients and family members is by tapping into your own moments. I often rely on three of them, from different times in my life.

Parent. My wife and I had our first child during the end of our residency training in Philadelphia. Our daughter was born prematurely and needed urgent support of her breathing. While in the neonatal intensive care unit, an air pocket formed around one of her lungs, making it difficult to breathe. To allow her lung to expand, a small chest tube was placed between her ribs to drain air out of this pocket for a few days.

After the first tube was removed, a second pocket immediately formed and she needed another chest tube. It was a struggle for my wife and me to remain positive each day when our daughter seemed to improve one day and then worsen the next. Seventeen days after she was born, we were finally able to take our daughter home with us. She appears blissfully unaffected by the experience, her only reminder the small scars from her chest tubes. Our daughter’s hospital stay did, however, create forever moments for her parents. Remembering them helps me better connect with how family members feel during prolonged, invariably stressful hospitalizations of their loved ones.

Patient. In the middle of my second year of residency, I developed a progressive, unrelenting headache. A CT scan showed that a small cyst in the center of my brain had suddenly blocked the circulation of fluid inside my head. I needed urgent brain surgery to remove the cyst and relieve the pressure.

My surgeon’s personalized approach toward both me and my wife inspired us to trust him implicitly before an intimidating surgery. Although I’m sure he discussed the potential risks of the surgery, what I remember today are hearing the risks of not doing the surgery, including death. I recall telling my wife that everything would be okay as I was wheeled down the hallway toward the operating room.

As an obstetrics resident who had done many surgeries, my wife was understandably worried about the unpredictable events that can occur during any operation. Mine was successful, with no long term effects other than a scar. That forever moment as a patient motivates me to do everything I can to develop trust with each of my patients.

Physician. As an internal medicine resident in the intensive care unit, I worked with a newlywed couple the same age as my wife and I were at the time. She was extremely sick with an aggressive cancer. I stood with her grieving 25-year-old husband, talking about end-of-life choices for his wife as tears slowly rolled down his face.

I tried to envision how I would feel if my wife were this sick at such a young age, but I couldn’t fully imagine how painful this moment was for him. I carefully put my hand on his shoulder and said, “I am so sorry.” Afterward, I sat in a nearby nursing station and put my head in my hands, desperately wanting to do more to help the man and his wife. This was a deeply personal experience for me because I directly related to his perspective as a new husband. That moment clearly shaped my belief in the durable impact of forever moments on providers.

When these moments were happening, I didn’t realize their importance or their longevity. But when I turned 40 last year — an age neither of my parents reached — I finally recognized the potential lifelong impact of a moment.

Health care providers have an enormous responsibility, and an incredible opportunity, to positively contribute to forever moments, which can potentially affect patients and their family members forever. We should rely on our own experiences as family members, patients, and providers to better understand and connect with patients and families as they adapt to intimidating and often frightening medical information and begin forming these moments.

With the continued push in health care to optimize measured value and statistical outcomes, it is increasingly important and inherently valuable to make it possible for health care providers to be present, focused, and connected in a personal way to each patient and family as they encounter their forever moments.

* Nathan Merriman, MD, is director of endoscopy and co-chief of gastroenterology at the Christiana Care Health System in Delaware.