Good For You, Channing!
A colleague shows wisdom beyond her years.
I'LL NEVER FORGET when I met Tommy Caplan.
It was after 1 a.m. on a midwinter night. I had just finished examining a patient whom I was transferring out of the medical intensive care unit to the general medicine service. As I maneuvered through the narrow hallway of the MICU, a windowless chamber where the time of day is easily forgotten amid the unrelenting cacophony of monitors, ventilator alarms and staff, I nearly ran smack into an elegantly dressed, jolly-looking man in his 50s.
As I muttered a polite, “Excuse me,” and started to walk around him, he extended his hand and said with a warm smile, “Hi, I'm Tommy Caplan. Are you one of the residents working in the MICU?”
This chance encounter would mark the beginning of the unlikeliest of friendships with a man whose elderly father was gravely ill.
I never took direct care of Tommy's father. That task fell to one of my fellow residents, Channing Paller, and the team on the Janeway Medical Service. But despite my lack of formal involvement, running into Tommy in the hospital wasn't difficult. It was unclear to me when or if he ever slept. Whether in the ICU or on the general medicine floor, Tommy sat at his father's side or hovered just outside his room so that his dad would not be alone. As I rounded on my patients on the same floor, I came to expect and enjoy the interruptions that Tommy provided. A well-educated writer who seemed simultaneously proud and humbled by his high-society status, he was conversant on topics ranging from international affairs to health care policy to the Johns Hopkins tradition to—sometimes—the severity of his father's illness.
I never knew quite how to tread. I was not immediately comfortable asking Tommy about his father's condition. After all, I was not actually part of this patient's physician-care team. But Tommy seemed aware of my hesitation and would often offer updates and introduce the topic himself.
Over the next three months, I witnessed the evolution of a fiercely loyal son coming to grips with his father's—and perhaps his own—mortality, facing ethical questions and decisions that both reveal and build character. I was profoundly affected by this son's extraordinary commitment to his father. And though I never told Tommy this, at times it prompted me to examine my own relationship with my dad, praying that I'd have comparable strength were I ever faced with similarly excruciating circumstances.
On a Friday morning in April, Channing called me to share the sad, though not surprising news. Tommy's father had died the day before. His son had been at the bedside, without the invasive scurry of activity that all too often accompanies death in the hospital. Son and doctors together had agreed that the outcome was inevitable and that it should occur with dignity rather than alarm bells.
Channing was a key player in all of this. After three months of nearly round-the-clock responsibility, she had developed a close personal and professional relationship with patient and son. Now, on the morning after his father's death, Tommy had telephoned her. Might she and I be able to join family and friends for the Monday afternoon memorial service? Channing and I discussed it and, despite some mutual hesitation about injecting ourselves into the most private of family moments, we decided to attend together.
That Monday, we left the hospital and drove the 20 minutes or so to a suburban cemetery sprawled on rolling green hills. The setting was remarkably peaceful. It was unseasonably warm, with a gentle breeze flapping at the suit jackets and hats of the 150 or so guests assembled at the gravesite. Channing and I stood in the back, feeling slightly out of place, two decades younger than most in attendance.
After an honor guard procession and an introductory prayer offered by the family's priest, Tommy stood to speak. He thanked those in attendance for what they meant to his father and for traveling to Baltimore on short notice. And then he did something as powerfully moving as it was unexpected. In the presence of prominent senior physicians who had been instrumental in his father's care, he singled out Channing.
For several minutes, he spoke about how vital she had been as the resident, how touched he had been by her attention to detail, by her stamina despite long hours in the hospital, and by “her compassion and wisdom decades beyond her years” in the waning days of his father's life.
I glanced at Channing. Her eyes were fighting a losing battle against tears. I could think of nothing more appropriate than to whisper, “Good for you.”
What a tribute. In a matter of minutes on a sunny Monday afternoon, interrupting the seemingly uninterruptible slog of internship, Channing and I were reminded of just how blessed we are to do what we do. And of how, though we often can't slow down enough to realize it, a house officer can play a key role in the eyes of patients and their families.
Softspoken and humble in her approach to nearly everything, Channing seemed slightly embarrassed by the attention she received from guests at the reception afterwards. As we bid farewell to Tommy, he embraced Channing. Then he shook my hand and looked me in the eye with the same warmth he had displayed in the MICU just three months prior.
I'm glad he thought to introduce himself.
Dan Munoz is a second-year resident in the Department of Medicine.