Navigating the walls of white and grey

The double doors automatically folded open, beckoning me to enter. I fumbled for my white coat that I had absentmindedly stuffed into my backpack, as I needed the “prop” of my coat to help me navigate through the day. There I was, approaching Pt number 1. I thought to myself, please don’t ask me if I can take away your meal tray as you’re done and not hungry and hate hospital food anyway. 

I spoke with confidence, hello, how are you today Mr. Gray? I knew before he answered that the pain of the abdominal mass and swollen legs would not be a positive response. My gosh, I thought to myself, liver cancer lives and ravages him. I had seen the overnight events indicating his need for increasing doses of morphine. So, there I was, about to offer a service I knew nothing about … hospice.

As I look back upon my journey in medicine, I can now truly say that the excitement the walls of white provided me, those white-washed hospital walls, continue to weave a complexity that makes me realize I will always navigate in the gray through these walls. 

Decades have passed since my first introduction to caring for the dying patient, humbling me to the truth that medicine may attract sharp minds, but will be humbled by the even keener challenge of various patient personalities.  I have come to realize the interplay of the nursing staff, the nursing aides, and family members .. all critical and dynamic pieces with a common goal to treat each patient the best we can. 

You see, there is no cookie cutter manual for the care of the hospitalized pt. Comfort lies in knowing that we can listen to the spoken and yet recognize the unspoken. Knowing what standard treatments prevail as first-line and optimal is just 1 facet of what’s touted as quality excellent care. The other part resides in our willingness and ability to recognize the needs of all patients, from all walks of life, and remain comfortable in practicing in the gray.