Relational Thinking

Friday was the last day at the Truly Wonderful Medical Center of the fellow who led all the teaching sessions last week. I really like him a lot—he is bright, funny, kind. I wished him good luck at the hospital where he will go next, and he thanked me and said that next year, he is going to San Francisco General. He said, “It’s a nice place. It could use someone like you.” That made me feel good.

That afternoon I was in the elevator with just one other hospital employee, who noted my badge and said, “You’re lucky to have that job.” I introduced myself, and after we stepped off the elevator, he added that he had just been “short” with someone and felt bad about it. He was thinking that he wished he could apologize to the person; he said it made him feel better when a chaplain got on the elevator with him.

Delia had sent me to see several patients on my own earlier in the week. On Friday, she shadowed me for the first time, and I forgot to do the one thing she specifically told me to do, which was to introduce her. There were a lot of people in the room, and while I was shaking hands with them, Delia quietly sat down on a chair a few feet behind me and I forgot all about her.

One of the palliative care social workers mentioned unpleasant interactions she’d had with a case manager, who also had gone in and riled up a family. Someone made an observation about analytic versus relational thinking: The former practiced at the expense of the latter may hurt relationships and needlessly upset people and/or force other care team members to spend precious time repairing relationships. In this case, a doctor ended up having to calm the patient and the family down. Yet another way of saying, “Don’t be a jerk.”

I visited a patient who was intubated, sedated and unable to communicate, and another, and another, and another. Much of the contact in palliative care is with other members of the care team and with the family members of the patient, less with the patient him- or herself.

On Friday night, I did the important monthly self-care practice of eating an entire pepperoni pizza, and then I slept for 12 hours. Saturday was a gorgeous, sunny, warm day. I went to Rainbow and did stuff for work. In the evening, several of us went to the beautiful four-story loft of a peer for a potluck dinner and to watch the movie Griefwalker. (She said excitedly during the movie, “For so long I have wanted friends I can do this kind of thing with.”) Afterward, she generously gave us rides home. I was squished into the back seat with Sam and our peer’s daughter’s baby seat. When I put on my seat belt, Sam shrieked, “Stop touching my butt!”