Methodist Journal

FEATURED GUEST EDITOR

ISSUE INTRO

The Burgeoning Field of Cardio-Oncology

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RECOGNITIONS

Barry H. Trachtenberg Leads Issue on Cardio-Oncology

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REVIEW ARTICLES See More

Heart Failure in Relation to Anthracyclines and Other Chemotherapies

Heart Failure in Relation to Tumor-Targeted Therapies and Immunotherapies

The Role of Cardiovascular Imaging and Serum Biomarkers in Identifying Cardiotoxicity Related to Cancer Therapeutics

Prevention and Treatment of Chemotherapy-Induced Cardiotoxicity

Cardiovascular Toxicities of Radiation Therapy

Electrophysiologic Complications in Cancer Patients

Vascular Toxicity in Patients with Cancer: Is There a Recipe to Clarify Treatment?

Future Directions in Cardio-Oncology

CASE REPORTS See More

A Rare Case of Pancreatitis-Induced Thrombosis of the Aorta and Superior Mesenteric Artery

Anomalous Origin of the Right Coronary Artery from the Left Main Coronary Artery in the Setting of Critical Bicuspid Aortic Valve Stenosis

Simultaneous Transfemoral Mitral and Tricuspid Valve in Ring Implantation: First Case Report with Edwards Sapien 3 Valve

Uneventful Follow-Up 2 Years after Endovascular Treatment of a High Flow Iatrogenic Aortocaval Fistula Causing Pulmonary Hypertension and Right Heart Failure

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER See More

Do Not Pass Flow: Microvascular Obstruction on Cardiac Magnetic Resonance After Reinfarction Following Primary Percutaneous Coronary Intervention

CLINICAL PERSPECTIVES See More

EXCERPTA

Cardio-Oncology, Then and Now: An Interview with Barry Trachtenberg

POINTS TO REMEMBER

Onconephrology: An Evolving Field

POINTS TO REMEMBER

Herbal Nephropathy

EXCERPTA

Rolling the Dice on Red Yeast Rice

EDITORIALS

Letter to the Editor in Response to “Cardiac Autonomic Neuropathy in Diabetes Mellitus”

Vol 15, Issue 4 (2019)

Article Full Text

ESSAY ON BEING A DOCTOR

Monday Morning

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Article Citation:

Maniar A. Monday Morning. Methodist DeBakey Cardiovasc J. 2019;15(4):310.



Through the generosity of Charles R. Millikan, DMin, vice president for Spiritual Care and Values Integration, an annual award competition was established at Houston Methodist Hospital among the resident staff. To enter the writing competition, residents must submit a poem or essay of 1,000 words or less on the topic, “On Being a Doctor.” A committee of seven was selected from Houston Methodist Hospital Education Institute to establish the judging criteria and select the winning entries. The following is the third-place winning entry for 2019.

It started as a regular Monday morning. After hitting “snooze” on my alarm three times at 5:00 AM, I finally got out of bed to get ready for my CCU rotation. I was an intern at that time. It was a chilly morning during the winter season, and I reached the hospital when it was still dark outside. I reported to the 10th floor of the Fondren building at the usual 7:00 AM call time and was assigned patients. Sitting at one of the computers, I started my chart review of my first patient, a 40-year-old male who was on a ventilator. The more I read, the more I felt my heart sinking deeper and deeper into my chest. This patient was a perfectly healthy male who had collapsed right after running a half marathon race the day before. The family was present at the time of the incident and reported that he had just complained of feeling slightly dizzy, collapsed on the floor, and was not breathing. Within a few seconds, EMS arrived and found him to be in cardiac arrest. They started rounds of CPR for about 30 minutes until they arrived at the hospital; the patient had not roused since he collapsed.

“Ok!” I thought to myself, “I can do this.” Taking a deep breath, I started walking towards the room, but my heart sank even lower when I saw his young, beautiful wife right outside the door with his parents, who were looking at him with longing and hope in their eyes. I reached the outside of the room, looked at them with as much positivity as I could muster, and stepped inside. As I looked around the room, I felt grief-stricken. Right above his head, I saw the smiling faces of his two beautiful children who were 2 and 4 years old in the photo. His entire room had been transformed overnight and was now filled with family pictures, wellness wishes, and flowers. They all looked so joyful and carefree in the pictures, not knowing that their entire lives were about to be shaken so tragically.

As I did my exam, I looked at the young patient who could very well have been sleeping… except for the constant beeps from the machines that were supporting his heart and lungs. I looked up, trying to say something positive to his parents, but all I could utter was “We are doing as best as we can, it’s all going to be ok.” I knew in my heart that it was a lie, but how can I say that to those aging eyes that are watching their son dying in front of them. Unable to hold it in anymore, I scurried out and rushed into the ladies room, where I saw tears pouring down my face. My heart was filled with gloom as the pictures of his family swam in front of my eyes.

As days passed with no changes, it was becoming harder and harder to go to that patient’s room every morning. All the reports coming back were not boding any optimism; in fact, “persistent vegetative state” was mentioned in one of them. Several tests were done, but there was no apparent cause for a healthy male to have a cardiac arrest so unexpectedly. I remember mentioning palliative care to the family at one point, but they were offended and asked, “He is not dying, why does he need palliative care?” However, I noticed that with each passing day, the family seemed to start accepting the fact that something was not right, and that things might not change. It seemed like in their hearts, deep down, they knew the truth but were too scared to speak of it. After several weeks of discussions between the family and primary care doctor and opinions from specialists, the family accepted the fact that it was time to let go, and they signed the consent to withdraw life support. The patient lasted for 5 minutes after the machines were turned off, and we saw the straight line on the EKG monitor.

It has been almost 2 years since I saw that patient, and even today I remember it as if it was yesterday. He taught me a very important lesson in life that inspired me to become the physician I am today. Being a doctor, we are always thought to be the strongest human beings on earth. We are expected to break bad news to our patients but not cry in front of them. But I realized that sometimes it is okay to shed a tear, it is okay to give a hug and tell them that “we will fight for you together.” Another thing he taught me is that life is too short to fight, be stressed, and be unhappy. It can end in the blink of an eye.

Although it is important to plan your future, it is much more important to live your present. In the rollercoaster that we call life, we often get so busy in our professional lives that we forget to love and cherish our loved ones. Sometimes it is important to forget about all the problems and stresses in life, wake up in the morning with a smile on your face, and be happy to be alive, breathing, and in good health. It reminds me of a very true quote by Emily Dickinson: “Find ecstasy in life; the mere sense of living is joy enough.”

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