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Title: Cover Art Artist’s Statement: N = 1: An Internal Struggle
Year: 2015
Abstract: Waiting for the end Assured this will change By those who will never know The cancer within Prisoner of my mind Enslaved by this so called life Cancer eats my flesh Let go of your grip This is the end my dear friend Cancer ate my soul Death is my way out It is time for me to go I bid you farewell On the cover of this issue sits an elderly gentleman, resting on his cane, deep in thought; this image represents my grandfather. I wrote the poem to reflect what I imagined was going through his mind as he lay dying of lung cancer in the hospital. The inspiration for this artwork was the feeling I had as I stood by his bedside during this time. He was in a hospital room, on tuberculosis (TB) precautions. The hospital was waiting for the TB test results to determine whether he was contagious, and I remember the admonition our family received from my grandfather’s caregivers: “Only one person can enter the room at a time, and you have to wear a mask, gloves, and gown.” When my turn came to enter his room, I heeded all of the warnings and donned the protective gear. But as I approached my grandfather’s bedside, it made no sense to me to remain insulated from him during his final moments. I had spent my life around this man, and my own TB tests had all been negative. So, I took it all off. I wanted to be able to touch his hand, and for him to feel my skin against his. I wanted to let him know that he was not alone. My grandfather appeared deep in thought, intermixed with periods of despair and fear. He worried about what would happen to my grandmother, Aghdas, once he was gone. He hung onto dear life, day by day, until the day my father whispered in his ear, “I will take care of Aghdas.” After this, he chose “DNR/DNI,” indicating that he did not want to be resuscitated or intubated if these measures were needed. The nurses continued to draw blood, even though my grandfather’s arms were already painfully bruised where they had been taking blood for daily labs. My father asked, “Why are you doing this? He has said that he doesn’t want any interventions.” They replied, “It is hospital protocol, and the physician put in the orders.” Despite knowing that my grandfather would die if he was not put on mechanical respiration and understanding that my grandfather had refused such an intervention, the physician ordered daily blood draws, only adding to my grandfather’s discomfort. My grandfather did not want this, so why was this dying man being tortured with needle sticks? My father would not allow any more blood draws. Eventually the order stopped and my grandfather was allowed to spend his final days according to his own wishes. In following protocol, my grandfather’s caregivers lost sight of what was best for their patient. I remember a piece of advice from a physician mentor: “You must work hard and dedicate yourself to patient safety, care, and well-being. Remember it is a privilege to take care of someone in need, not a right. Every day before you start work, say the following (as I do): Today I will give 110%. That is all you need to do.” As physicians, we should all follow this simple rule. Maryam Soltani, MD, PhD M. Soltani is a second-year resident in family medicine and psychiatry, University of California, San Diego, San Diego, California; e-mail: msoltani@ ucsd.
Appears in Collections:Academic Medicine 2015

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