What It Sounds Like on the Other Side of the Stethoscope

This article is dedicated to my family, specifically my mother, who exemplifies what it is to have and do the work of a selfless and giving heart, and to those who have taught me the lessons learned on the other side of the stethoscope.

As I sat there, having started the day like any other with the hustle and bustle of hospital medicine and residents and making sure every ‘I’ was dotted and every ‘T’ was crossed, I was quiet. Listening and yet not quite hearing, feeling the stillness between each of my breaths as my mother was working her way through a lengthy explanation of her medical journey over the past month to get to – “I have cancer.” 

We, as clinicians, barely have the exacting and eloquent words to conjure up when a patient has such a diagnosis to carry with them. When it is our own body, or family, friend, colleague, the landscape and vantage change. We no longer see the algorithms and standards of care charts roll over our mind; we see our loved one with all the history, stories and contexts in which life has afforded us such gifts. The waters of our clinical reasoning go from clear to murky at best. And it is in these times we must lean in and on, throw off the algorithmic, and often myopic, optical lenses – allowing our hearts and souls to have space to breathe in the reality of this muffled sound – no longer is it a lub-dub or other variant of auscultation, but we are now hearing the sound of the persistent heart beat within the chest of our loved one echoing in our ears. No stethoscope needed – we heard with our hearts the 6/6 heart sound from across the room. 

What do we do in this space? Well, admittedly, I initially got busy. I started the “doing” that we all do in medicine when hearing the words “cancer, confirmed with tissue biopsy” bestowed upon a family member, loved one, patient, or stranger. Making appointments, reading the latest articles, treatment plans, who to see for this appointment or that procedure. On and on down the various rabbit holes which we typically navigate with ease and judicious evaluation, now blurred and as nebulous as a roller coaster in the dark. 

In one of my “reaching’s out,” I contacted, with my mother’s permission, a mentor in the field of oncology. I presented my mom’s “case” as dutifully and succinctly as I could, given the pertinent positives and historical data as clearly and thoroughly as I could muster. Stethoscope metaphorically ‘round my neck. However, I was met with a “how are you?” and “how is your mom doing?” I felt myself switching the hat back to “this is my mom who is sick” and named the sense of juggling multiple hats with my mentor. Rather than simply agreeing with the statement and an “oh yeah, yeah, I could understand that…,” the response stuck with me. He stated, “You don’t need to juggle hats. Your mom has a doctor.” And I wasn’t that doctor. “You, [Angela], get to be a loving daughter and a translator in this. And that is all you need to be.” The statement stopped me in my Med-Head tracks. I realized just how right he was. And what a profound weight off my shoulders. I wasn’t her physician. And, in all honesty, wouldn’t want to be. I am fully aware that not only would my clinical judgement be less objective, less accurate, less appropriate, but I would be infringing upon my dear colleagues’ opportunity to have that sacred physician-patient relationship that I so cherish with my own patients. I would be infringing equally on my mother’s opportunity to experience that same sacred relationship with my colleagues. Instead, I got to be a voice for my mother, an advocate, a translator, and a serving daughter. I have been able to plan with my family, anticipating needs like food, pillow support after surgery, drain care, chemo needs. I have been an interpreter of testing results, describer of studies and medications, anticipator of next steps. The sacred relationship of mother-daughter is also intact.  

This journey has not been easy. But this journey is oh so worth the time, energy, sacredness that get to be upheld. We all face moments of this magnitude in our experiences. And we get to serve those closest to us with sacredness and fidelity.  

Those of us who have, are, or will be in this space – I encourage you. I extend a heartbeat to your journey. We are not alone and the weight and magnitude of the care for others in our lives does not rest entirely on our shoulders. We are surrounded by many, cared for by many, and we have the unique opportunity to love our loved ones in a special way. We get to be an advocate, a translator, and a child/friend/loved one. Weight shared, ears open and heart extended. Auscultation on the other side of the stethoscope.

Note: The views expressed in this article are the author’s own and do not necessarily represent the views of ACOI.