During my first seven semesters as a medical student at Gadjah Mada University in Yogyakarta, Indonesia, I spent most of my time studying and in classrooms. I rarely spoke with real patients in a hospital setting. Then I started visiting the neurology ward at Dr. Sardjito Hospital.
I was gathering data for my thesis, an assessment of the oral contraceptive pill as a risk factor for ischemic strokes. This type of stroke is the most common and it occurs as a result of an obstruction within a blood vessel supplying blood to the brain. At the hospital I would review the medical records of newly admitted stroke patients, then interview them to find out if they were taking the pill. It was a slow process.
One cold, rainy evening October evening, I was in the neurology ward desperately “hunting” for the final three patients I needed to complete my study. The records showed that there was a 43-year-old stroke patient, whom I will call Ms A, in the ward.
Holding a patient questionnaire, I walked towards her room. I didn’t see any doctors or nurses; the ward was quiet. Ms A’s dimly lit room had eight beds. I could see dark clouds and heavy raindrops through the window. The familiar “hospital odour” hung in the chill air.
Ms A was lying on bed 4B, clearly still weak as she was still recovering from her recent stroke. There were no relatives or friends with her. Even the bed beside her was empty. I sat down on a chair next to her bed, and in a low voice I introduced myself and asked how she was doing. She softly replied that she was getting better but the left side of her body was still weak. When I told her that I wanted to gather some additional information from her, she agreed.
The questionnaire consisted of three simple yes-or-no questions. After I finished, I prepared to leave so I could go through more medical records. Before I could stand up, Ms A spoke up in her weak voice. “I haven’t seen you here before, doc. Are you new?”
“Not really, Ma’am. It’s just that I don’t come here every day,” I replied. She started making conversation, asking where I was from and why I was working so late in the evening. I was surprised someone in her condition would want to talk.
“Doc, do you think I can get back my normal life?” Ms A asked at one point.
Deep in my heart, I thought, God, I wish I was your doctor so I could answer you properly..
I replied that while I didn’t know much about her case, I could tell her what I had learned about the recovery of stroke patients. Depending on the severity of the stroke, quite a number respond well to rehabilitation. I was reluctant to go into too much detail as I was only a medical student.
Ms A started talking about herself. She told me that she had three children in primary school, who were staying with a neighbour. “My husband died a year ago and I’m the sole breadwinner of my family. We are not rich and my pay as a cleaner is exactly enough for me and my kids.”
I didn’t know what to say. Looking into her eyes, I desperately tried to remember the lessons from a communication skills class I had taken a few years earlier, but my mind was blank. I cursed myself for not paying more attention.
Without realising it, I had begun holding Ms A’s hand. Since I didn’t have anything to say, I just sat quietly while she talked. That’s when it occurred to me that she was not expecting any reply from me. She just wanted me to listen.
The conversation went on like this for about 20 minutes. She shared her difficulties and sufferings, talked about her husband, who was killed in a car accident, and her struggles to earn money. She also expressed her fear about what would become of her children if something bad happened to her. All I did was nod my head as a way of showing my sympathy.
Finally, Ms A stopped talking. “I’m very sorry for keeping you here to listen to my problems, but I feel relieved now. I had no-one to pour out my problems to.”
A single tear fell from the corner of her eye. I stroked her hair and continued to hold her hand. Finally, I knew what to say. “It’s OK, Ma’am. It’s part of my duty.”
“Thank you, doc, thank you so much.”
She let go of my hand. I stood up, covered her with a blanket, waved goodbye and left her alone in her bed. A few days later, when I returned to the ward, I discovered that Ms A had been discharged as her condition had improved, though she would still need rehabilitation.
Ms A taught me one of the most important lessons a doctor can learn. Sometimes patients do not need expensive medicine or state-of-the-art technology. They just need someone with the patience and willingness to lend an ear and spare a little of their time. For me, that is one of the best things a doctor can do for a patient.