I held a stroke patient's hand yesterday. It was his second stroke. He wasn't even my patient. I was just sitting in to observe a transcranial doppler and he just happened to be the patient. But as I was leaving I caught his eye, and he looked at me while he was laid out on the stretcher, unable to move his right arm, with a tube stuck in his nose and a doppler probe on his right eye. He was edematous and it was obvious he was having difficulty breathing. He could not speak. And I thought of how my mother looked before her second open heart surgery--I thought of how my dad, who's hypertensive, might end up just like this man. And I smiled at him encouragingly, and for one wonderful moment he smiled back--and then to my horror he burst into tears.
I tried to get him to calm down, telling him that he shouldn't cry or his BP would spike. I held his left hand, the one on his stomach, and tried to stroke it reassuringly, and it was the most amazing thing ever to feel him stroke back, though a little bit weakly--his thumb moved over mine even though he was still crying, and seemed unable to stop. He made no sound--his shoulders just shook and tears streamed down the sides of his face--and somehow that makes it worse.
A day later and I'm still crying. I know that I will come face to face with death many times over the next years. Rather than reassure me, or remind me not to make a big deal of it, it just makes me more afraid--for my parents, for my patients, and most selfishly, for myself.
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