Dear doctor: please do not forget the patient’s spouse

They sat in front of me: she and her husband. The wife was brave in a way that concerned me. Before I started, she said to me: “Please doctor don't talk to me, talk to him. He’s terrified and worried and didn’t sleep last night because your secretary told us to come here today.” I looked at him, his eyes were filled with tears as if he had prepared himself for the coming pain. I said: “I don’t have the best news. The mammogram showed that you have a breast cancer and—” He entered a sobbing fit; crying heartily for a long time. She was the one trying to calm him. I waited until he stopped—or maybe he’d shed all his tears (or so I thought and hoped)—but before I spoke again, she asked, “What is our next step?” I tried to direct my face and answers to her but was unable to because of his reactions and interruptions. Read: Dr. Jabir Jassam: A sick doctor shouldn’t wait eight hours in the ER I explained to them what we should do and the plan. Through all this, he was wailing in front of me with a burning heartache like a child who just lost his mother. Tears flowed from him like a running river. I wondered to myself, where does this man, who is clearly in love with his wife, get all these tears? How can a person shed tears with such abundance? He said: “I know the wait time is long in Canada,” and then started another crying episode. After he stopped crying, I said, “It is not long in such a situation.” “Even with COVID-19?” “Even with COVID-19,” I replied. He looked at me and said: “Please, doctor, if you think the wait time will be long, I’m ready to take her to the U.S.A.” “I assure you first that the care would be the same if not better and that the wait time will not be long, so why would you spend your money unnecessarily?” He looked at me and said tenderly, “She is my wife, I will sell everything we have to treat her.” “You do not need to sell anything, she’ll be fine, breast cancer is not as scary as before, it can be curable.” “Curable?” he asked eagerly, as if I opened a door of hope for him that he did not know existed. “Yes, it is.” He put the public health recommendations aside, got up from his place and came toward me and kissed my head. “Didn’t I tell you that everything would be fine?” He said, “Yes, but I thought you said this to comfort me. Doctor, as you know, we don’t have kids. She is my soul, girlfriend, my wife, my sister, my mother and my daughter, and when she got sick, all of them got sick at once.” I felt the sincerity of his words that touched me to the point of choking. I felt as if there were two hands pushing on my chest. I had a huge desire to cry, but I managed to gather my strength. I looked at his wife and said: “You must be a great woman to be all of these women in one.” We then decided on the plan and started the process Three months later Three months later, I accidentally ran into him in a grocery store. He didn’t recognize me; we were wearing our masks. I approached and when he recognized me, he shook my hand. Then his eyes started to look red, his tears to flow and his voice became sad. I asked him if he wanted to visit me the next day in the clinic so we could talk. “I would love to. I wanted that for a long time but I was embarrassed to contact the clinic,” he replied. We agreed that he would come the next day and I made sure that he would be the last patient so that we could sit longer. The appointment The moment the appointment started, he began wailing and shedding tears but then pulled himself together. “If you wait until I’m done wailing, you would wait another hour. Let’s talk.” “How are you,” I said. “It must have been a difficult few months for you.” “Yes, since she started chemotherapy, I am in constant pain, my life has been turned upside down and there is nothing to cheer me up anymore. My day turned into pain and my night into tears, and I no longer wanted to do anything. The problem is I have never gone anywhere in the past without her. I used to take her everywhere I go even for work-related trips. She became part of me and now I have to do everything on my own, go by myself, visit places we visited together. Every place we were together makes me want to cry and remembering everything we did has become a constant pain for me.” He broke into a sobbing fit and then went on: “When I found her saying goodbye to her hair—when it started to fall after the chemo—I could not stand that scene: she was talking to her hair and saying goodbye in painful words. I had chest pain, suffocation and shortness of breath. I ran out of the house looking for a breath of air hoping it would restore my balance. I felt at that moment the death was closer to me than any time before.” Now maybe for a moment, I thought, this is a bit much. But then as I looked at the man, tears in his eyes, a crying voice, I saw a man who looked 20 years older than he had before all this. I asked, “What saddened and terrified you the most?” “The fear of losing her. This thought makes me feel that the world is very tight and cannot contain me, and that I was alone in it without her, and the more I think about this, the more sadness and pain I have, I can’t imagine my life without her.” “How is she now?” He said, “Believe me, she is better than me.” I said, “I know that these are difficult and painful days, but they will end soon, sooner than you think and the end will be better than you expect. It is a hard detour in your road but you will soon be back to your regular path. When we are in a dark place, it is difficult to see the light, but we can imagine and contemplate it.” We parted but met many times afterward. Falling short He felt the comfort for having vented and released the pain and tears he carried inside him. I could see the comfort in his eyes after each visit. He thanked me a lot. I assured him that this is part of our job, but I know in my heart that we fall short in that. We try to do everything for our patients, but we unfortunately forget their spouses. We may even sometimes get annoyed by their complaints and their many questions, fears and anxieties. The spouse’s pain is different from the patient’s pain. They fear that they may live without their second half because they see this half in pain before them and they do not have the ability to do anything. After one year After one year, the man and his wife’s lives returned to normal. I began to see the smile on his face again, after his soul had recovered, and after his mother, sister, wife, girlfriend and daughter have come back. On their last visit, he looked at me and said, “I don’t know how I would have done that without you.” I will never forget that statement. . . . After that, I decided to try my best to pay more attention to those spouses whose second half get sick and invite them to vent and to provide them with continuous support. Dr. Jabir Jassam is a family physician in Ottawa.

Dear doctor: please do not forget the patient’s spouse

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