Watching the health care system morph into something unrecognizable, I still believe the physician-patient relationship is THE MOST powerful therapeutic force in medicine, yet its value has been overlooked by those managing health care reform. Administrators and bureaucrats ignore the importance of continuity for both the patient and the physician, to our detriment. When your doctor KNOWS everything about you, they can provide the BEST quality care possible. Let me tell you about an extraordinary patient-physician relationship that has kept me grounded throughout my career.
Garrett is over 6 feet tall today; it is hard to believe the night I met him, he was the same age and size of my youngest son right now. A completely healthy boy having a severe allergic reaction to a Penicillin shot received in Wyoming was being airlifted to our hospital in Denver for intensive care. On call that night in the PICU, I remember exactly what he looked like as he rolled through the doors. He was stable, breathing on his own, and had swollen and cracked lips.
I remember thinking he would improve quickly, but instead I spent 90 days caring for this child and the experience was like riding a roller coaster. His allergic reaction was not entirely relieved by epinephrine, so numerous complications ensued. He was intubated multiple times, spent weeks on a ventilator, suffered a cardiac arrest requiring chest compressions, received multiple rounds of antibiotics, had pneumonia, a chest tube placed between his tiny ribs, and even a fungal infection by the time he was on his way to recovery two months later.
At the beginning of my third year I became a supervising resident, Garrett was transferred to my service. I knew his story better than any other doctor in the hospital. The next 30 days was spent rehabilitating all he lost while lying in a hospital bed. Many afternoons I sat with his family talking, teaching and learning, crying, and sharing hopes and dreams. It was the closest patient-physician relationship experienced during my three year pediatric residency.
He continued to become stronger each day through physical, occupational, and speech therapy. The only evidence remaining of his ordeal was a small divot in his lower lip and a hoarse voice from damage to his vocal cords after being intubated multiple times. The day he was discharged home was among one of the happiest in my pediatric career.
Many local pediatric specialists tried to determine how an antibiotic shot that had saved millions of children over more than 5 decades triggered such an unusual immune response. We still do not have those answers today. I have never seen anything like it before or since; the specialists in practice 50 years had never seen anything like it either. It is unlikely I will ever see a reaction like this throughout the remainder of my decades in practice.
His family and I have continued a close relationship for the past 15 years. His older sister is a sophomore in college now and Garrett will graduate from high school this year. There have been achievements and setbacks in both our lives. His mother and I made decisions about his care over the years together and had many conversations when there were bumps in the road. They attended my wedding and have watched my children grow up despite the 2,000 miles separating us, because of our deep bond.
Seeing a child through life-threatening illness and having them survive has sustained my heart and soul as a primary care physician. Unfortunately, this relationship is being attacked on many levels by people who are not patients, parents, or physicians. I am a better doctor because of my connection to Garrett and his family.
Above is a picture of Garrett with me at my wedding (I am clearly more excited about it than he is!) My relationship with this young man, his sister, father, and especially his mother are the foundation of why I became a pediatrician in the first place. Filled with doubt in my darkest moments, his story of triumph always brings me comfort and hope. It reminds me there will be losses and saves, but the life-long, enduring R-E-L-A-T-I-O-N-S-H-I-P is what makes it all worthwhile.