Gina: When the patient heals the Doctor

By Rob Rutledge February 12, 2019

I was surprised to see Gina standing up, beaming at me as I walked into the examination room. My resident doctor had just given me an overview of Gina’s case. Ten years ago I had treated Gina, then age 60, with radiotherapy when she had early breast cancer. Gina had been well all those years until a couple of months ago when she developed a nagging cough and shortness of breath walking up stairs.  Her doctors had found an egg-sized lump in the middle of her chest and a biopsy confirmed that her breast cancer had returned.

Gina extended her arms out towards me, her voice warm “Oh, Dr. Rutledge, I was so happy to learn you are going to be my oncologist again.  Can I give you a hug?” She had lost weight and looked frail. Her golden hair had thinned markedly but she still had a twinkle in her dark brown eyes.

We held each other tight for a moment then she looked me up and down “You haven’t changed a bit.  What’s your secret? Must be something wicked!” she teased with her Newfoundland accent.  I winked at her “Hanging out with people like you.” We bantered back and forth before getting down to the business of making plans for radiotherapy to this lump in her chest. Gina seemed completely at ease – she was more concerned with the inconvenience she’s causing to her daughters then her own health.

That night I got a message from the emergency department that Gina had a mild heart attack and was admitted to the coronary care unit (CCU). The plan was to get her well enough to deliver radiotherapy. But the news kept getting worse as the week wore on. She needed to be intubated one night, and, though the tube was out, her breathing hadn’t improved. The cardiologist asked me to sit down with Gina and her family at the bedside.  I would have to decide to try emergency radiation, or tell Gina and her family that we would simply keep her comfortable.

The CCU room is crowded. I sit at the bedside while one of her daughters stands beside me rubbing Gina’s back, and four other adult children sit in a semi-circle of chairs across from us.  Gina is struggling, smothered in a mix of tubing, probes, and an oxygen mask. Her breaths are coming fast and hard, sweat forms on her furrowed brow. “Can I have something to calm me down”, she pleads, eyes widening.  “I feel so short of breath”.  The resident doctor tells her that if they give her Ativan she won’t be able to stay awake and listen to what I have to say.

Feeling like I need to get some key information in fast I launch into a quick barrage of statements. “Your breast cancer has come back.  We can’t cure you of your cancer. You’re too sick to undergo radiation or chemotherapy. I expect this lump in your chest to grow…”  I look up at her oxygen monitor and watch the numbers start to fall. Gina is looking scared, shifting in her bed, trying to get comfortable. The resident doctor calls in the nurse and respiratory therapist – everyone is scrambling, bumping into each other, adjusting oxygen masks, giving another inhaler, injecting a little morphine, adjusting the pillows.  I wait and watch Gina closely. Waiting.

I reach out and hold Gina’s hand, careful not to disturb the oxygen probe clasped to the tip of her finger. Gina looks over to me. I say, “I’m sorry my hands are so cold”. She winks, “It feels good. I’m too hot in this bed”. We hold hands in silence while her nurse and therapist work away. At one point I suggest increasing the amount of oxygen she is getting.  I look up again at the monitor and Gina’s numbers are climbing into the safe range. Gina’s body begins to relax.

“Gina, I know this is such a difficult conversation but do you understand why we shouldn’t be treating you?”  Yes, she says sadly. “I just want to get home”.  I am completely honest with her. I tell her I don’t think she will get home, and later on in the conversation, that her life would be measured in days and not weeks. Our goal is to keep her comfortable and deal with problems as they come up.  I look to the circle of her kids with tears in their eyes – there is so much love in that room.

Gina takes my hand in both of her hands and begins to stroke my hand lightly.  We look into each other’s eyes in silence – she has such a loving presence – and our spirits meld together. And then we joke again about her never shutting up – even when she was intubated she was still writing messages to her family like telling them she’s thirsty enough to drink Niagara Falls.

I walk away from being with her filled with a sense of awe and inspiration – rejuvenated from basking in Gina’s love.

Comments

Doreen says

Oh wow. Gina is a wonderful lady. I had the opportunity to meet her in my home. I am so happy meeting such a beautiful lady like Gina.
May her soul rest in peace.

Gwen Rivet says

So beautiful !!
This family is indeed filled with love

Bless her heart

Denise says

This is the most beautiful thing a doctor could do and say about a patient....aunt Gina will never be forgotten

Patricia says

Gina was such a beautiful person inside out. She will always have a place in our family's heart.

sheila malcolm says

This was wonderful and I would like to say a few words at her funeral on Saturday. .I was her volunteer for a year and came pretty close to her.

Debbie Dunne says

This is a beautifully written article about something that has touched many people and although I didn't know Gina, she certainly was very brave and loving, truly inspiring.

Leanne says

Rob, you continue to inspire and amaze. So very grateful for doctors like you. Much love and blessings from Sam Smith's mom and family.

Carol Moulton says

I didn't know Gina, but I did know some of the family, and I know Gina was a very special person, would like to have met this lovely lady. She has a very loving and thoughtful family and she will always be with them in spirit. RIP Gina.

Carol Moulton says

What a wonderful relationship between a Dr. and his patient. RIP beautiful lady.

Paulette White says

Gina had a wonderful Doctor, and I am sorry I never meet her ,she sounds just like her sister Marg.RIP

Tawny McDonald says

We were touched by the care that Dr. Rutledge showed to our mama throughout her entire relationship with him, but particularly during his last visit with her in the hospital. He was very kind, attentive and gentle with her as well as very supportive to her children during such a difficult time. It really did feel like he dropped everything to come and be with her that afternoon, and watching the two of them together is not something that we will ever forget. Although he delivered the worst possible news that she could hear, and she was very sad, I also believe that she felt safe under his care and knew that he wished he could have done more. We are grateful for Dr. Rutledge and the rest of the cardiac care unit staff at the QEII Halifax for everything they did for her.

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