A True Love Story

First things first. Go get some tissue. Sincerely.

Next, watch this video. It's beautiful. Seriously. Watch it.

Did you love it? Of course you did. Daily love letters? Planning for a partner's life after you die?

Now you may continue.

This is a love story that I first learned about more than 10 years ago. They were one of my favourite couples who came to my restaurant when I was serving. They came from India during a time when you did not date outside your caste. Especially not the untouchables, but love goes beyond these invisible borders when you are good people.

They went to school and were educated in medical fields. One became a brilliant researcher and teacher, the other a fantastic clinician working to save lives. I have had the honour of hearing stories from the students and patients of these couples. They are well loved by those they serve.

The love they feel for each other was obvious in their dealings with each other - the tenderness they showed one another over their table through touch and words, the way they shared their meals, Mrs. would always bring home a treat for Mr. when he wasn't able to make it to dinner. They would tell me stories of their courting and their move from India to Canada. I would often end in happy tears with the two of them. (by the way, can you see why Family Medicine had to be where I'd end up?)

Fast forward over my medical training.

I am doing a hospital elective in the town I used to live in, where I first met the brilliant couple.

We are paged to see a patient who is not doing well. There is a long history of cancer and chemo complications. I'm shocked to recognise my Mr. Love Story on the hospital bed. He looks unwell. Very unwell. I can tell immediately that he's actively dying.

We catch up, I learn the course of his metastatic prostate cancer over the past year. About all the treatments he has been through for the past year. About how Mrs. LS has never left his side, sleeping many nights by his hospital beds. The entire time, they are holding hands, looking at each other with the doe eyes I didn't even know I had missed. Mrs. LS tells me that the love she feels for Mr. LS is only growing stronger through all of this. Mr. LS's biggest concern is that he is leaving Mrs. LS with unfinished business. And how will she continue without him around? Their children will be some comfort but, as with all families, they are busy.

Next comes the part I hate the most. The goals of care talk.

They think they are in the ED for a quick fix so they can go home together. I tell them I think that Mr. LS is dying. They aren't surprised but they are sad. Mr. and Mrs. LS want to have a few more months together. I'm hoping for a week. Mostly I'm annoyed that the colleagues of the LS's didn't let them know (or at least ensure they understood) during their treatments that Mr. LS was dying. I know it's hard to have perspective when the patient is someone you know. I learned that it is even harder when it's someone you love.

My colleague came to see the LSs and did the evaluation. My visit was to determine goals of care and ease the conversation for the next doc to evaluate and admit Mr. LS. The next doc came and told me that my week was overly optimistic and that Mr. LS would not have more than a day.

The funeral service was beautiful. Both communities came out to celebrate the life of Mr. LS and the love between him and Mrs. LS.

As with most of these painful encounters. I want to learn.

Lessons learned here:
1. Love stories are important. They are everywhere and give us something to hold onto when everything else is crappy. Ask patients and find out what their love story looks like.
2. Having perspective with patients who you are emotionally attached to is impossible. Ask for help. Know where the boundaries are.
3. Find out patient expectations early in the interaction to best help your patient.
4. Serving others provides your emotional self with great nourishment and can allow a love to grow exponentially through adversity. I served food as a waitress but now I serve my patients. I am constantly overwhelmed by the lives my patients live and their willingness to share these lives with me.