The worst day of your life

“I suppose you’re going to tell me that this will be the worst day of my life?”

Coming from the mouth of a 10-year-old girl whose mother had just succumbed to an opiate overdose, the child’s words carried unspoken impact.

The priest who was telling me this story said he wasn’t sure how to respond.

This was back in the day when one of his duties was to serve as chaplain for the city fire department. The firemen would call him in on those sorts of impossible cases where no one had any idea what to do; cases like this one: a 10-year-old girl unexpectedly orphaned on the spot with no apparent next-of-kin.

By the time he arrived at the sparse apartment, other tenants in the public housing complex had started to filter in, each attempting in his or her own inept way to offer condolences and comfort.

“It was like something out of a Tennessee Williams play,” the priest said. “Everyone was concerned. No one knew what to do.”

“What did you say to her?” I asked.

Momentarily, the priest’s eyes regarded an infinite point in the distance; then he collected himself.

“I thought of all the bad things that this little girl would be facing in the coming hours, days, and weeks ahead. I thought of all the not-so-good things she might be facing for the remainder of her formative years, maybe even for the rest of her adult life.”

He lapsed into silence. Then the words came again. “Suddenly, I remembered that I had just lost my own mother. I knew how it felt. It felt like the worst day of my life. That gave me the courage to tell her: yes, this would be the worst day of her life; but there was always hope that somehow things would work out for the better.”

The hint of a tear glistened in the corner of his eye.

“Those are the ones that you always remember,” I said.

“Yes,” he said. “They are.”

Sometimes in our struggle to care for others, we must first learn how to care for ourselves, how to lay down our own burdens. In facing our own suffering and accepting our own wounds, we learn how to help others heal.

The patient-centered medical home (ain’t what it used to be)

Advocates of the patient-centered medical home tout the desirability of having all of this information in a central repository, readily accessible, complete. Supposedly, such a system will drastically reduce duplication of services, reduce the likelihood of medical error, and subsequently cut the cost of medical care. Conceptually, it all sounds so good—too good, as the adage goes, to be true. more»

Read more in my latest entry on the Musings blog of the JAAPA Editorial Board here.

JAAPA is the official publication of the American Academy of Physician Assistants.