FEATURE
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I saw a patient recently in the office whom I had not seen in over a year . I presumed COVID-19 was to blame for his absence , but there had been radio silence from him in person or via telehealth . I traipsed to the exam room prepared with my usual gentle tongue-lashing for missing out on regular appointments and opportunities to engage in his own care . I walked in the room and noticed straight away signs of recent crying . I offered the usual greeting and salutation , but it was evident something was amiss . In short order , he acknowledged the absence from clinic and unleashed a summary of what can only be described as an undeniably horrendous year . He recounted in some detail the sudden passing of his mother , his burdensome work changes due to COVID-19 , his dad ’ s grief and turmoil and his brother ’ s downward spiral into alcoholism .
When he concluded this summary , it felt as if a balloon had burst in the room , a balloon filled with a dark confetti of tears , angst , heartache and exhaustion . I was both stunned and simultaneously heartbroken for my patient . As the intensity in the room settled and we both took a breath , I removed my glasses , stopped typing , looked him in the eye and said “ I ’ m sorry .” And then , hard as it was for me , I didn ’ t say anything more . He smiled , for the first time during the visit , and said , “ Thank you .” I knew , as did my patient , that on that day , I couldn ’ t fix any of the issues in his life . I wanted to fix something , anything . However , I could say , and only say , “ I ’ m sorry .” Remarkably , those two words effectively recycled the heavy air in the room and we were able to salvage the visit , reacquainting ourselves with his long-term health issues . I like to think we gained a bit of mutual respect for each other during the visit . We acknowledged that we were sharing in his heartache but not looking to create more .
When the universe giveth , it often continues in abundance . Later the same day , I placed a call to my 30-something patient , on whom I had received an unexpected pathology report showing a new diagnosis of invasive lobular breast cancer . Empathy should never be far from the reach of a physician , and I knew a phone call was in order . I called to say “ sorry ” and to acknowledge mi dispiace . She was poised , as is her usual demeanor , and had already organized and completed two oncologic opinions for her diagnosis . She had chosen a treatment team , had a plan , and was ready to put that plan in play . I was proud of her for her aggressive and organized approach and we talked wishfully of her post mastectomy cancer free days ahead . I , however , could feel my mind swirling a bit . What else could I offer ? What more should I say ? Should I anticipate some of the complications and offer contingency plans ? I started down that path , asking about her support and need for mental health care . She graciously stopped me and made it subtly clear that she had a plan and she was on her game . I had said all I needed to say with two words and nothing more was needed . I got ahold of myself , consciously scolded myself for not learning my
lesson a mere few hours earlier , and simply offered an open line of communication should she need anything . I was not going to fix her cancer on the phone that day , nor did I need to . We both knew that her oncology treatment was not my show ; I was supporting cast and in that phone call my job was just that , support . The experience of saying “ sorry ” in that instance was hard only because I didn ’ t need to say anything else .
I cooked a meal a few weeks ago for an acquaintance whose husband had passed prematurely . My children attend school with hers and accompanied me to drop off the meal . On the way , I recognized that my children were likely feeling uncomfortable about seeing their classmate and knowing what words to say . I coached them , to avoid feeling anxious , with one simple rule : “ All you have to do is say , ‘ I ’ m sorry .’” I told them to let their classmate guide the conversation from there . She would let them know , if they used their emotional intelligence , if she wanted anything more . I assured them an empathetic “ sorry ” would be enough . My daughter , Lily Grace , whose creative young mind works in ways that my wife and I have yet to grasp and who I know has never once listened to an Elton John album , said , without missing a beat , “ Ya , and then ‘ sorry ’ won ’ t be the hardest word to say .”
Empathy is in all of us and , Sir Elton , Lily Grace may just have you on that one . Dr . Kolter is a practicing internist with Baptist Health .
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