Today went pretty well I think. Not perfect, but better than yesterday. I didn’t really end up writing things down, but I felt like my mind was a bit less foggy. There were a couple Spanish speaking patients that I saw today. It’s always hard to develop the same rapport that you can have with a patient with whom you share a common language. I try my best though. I look at the patient when speaking and not at the translator. I think I have a tendency to use less sympathizing or colorful or encouraging phrases when speaking through a translator, but I try. But also I think the translator feels a little awkward when they have to translate me saying things like, “I’m really happy to hear you are feeling better,” and will even sometimes paraphrase or just smile. That’s what I’m missing, and what I hope to gain by learning Spanish; being able to develop those connections without having to go through a filter. I can get by on certain parts of the interview and physical without a translator, but for a lot of the technical or more complicated stuff, I still need them.
Today we had a lecture related to end of life care. It was mostly centered around what to do when a patient request to continue palliative chemotherapy when it is determined that doing so would do more harm than good. The lecturer made a point that I thought was very important (well he made several, but to met this was the most impactful). When someone is in end-of-life care and the doctors have run out of curative treatments, we commonly hear in film, TV, other media, the phrase, “I’m so sorry, there’s nothing more we can do.” However, that is not true. There is always something we can do. It may not always be in the form of a pill or procedure, and it may not always extend a person’s life, but our role as physicians and healers should always to be to help our patients live their best lives based on their own values, regardless of the time they may have left. Sometimes that involves the stroke of a scalpel, other times words of reassurance or providing information. Sometimes it’s being present, other’s it’s giving space and being silent. There is always something we can do.