Dr. Stern treated my husband. He gave him quality of life with less pain for several years until he passed. Dr Stern was amazing to interact with and his kindness and sincerity really gave us confidence and hope. What a wonderful legacy his sister left in his heart.
God bless you and thank you Dr Stern.
3
This was excellent. Joseph, I don't know if you learned this from your sister, or you were always more empathetic, but this was one of the few pieces about a doctor learning compassion that talked more about the teacher than the pupil.
Well done. Great reading. Should be shared widely among young doctors.
5
Thank you for giving readers a window into what it means to be a compassionate sibling, human being and physician. By sharing your experience and vulnerability, you offer important insight about the role of compassion in healing. It is a lovely tribute to Victoria and her impact on you and your continued practice. I hope other physicians will take the time to consider what it means to their patients when their doctors provide treatment from the perspective of trained human to human in need.
17
This is a moving, heartfelt story from a talented writer. I hope to hear more from Dr. Stern in the future.
14
A wonderful tribute to you and Victoria! You have found a way for her spirit to illuminate your life and work.
11
This is a moving and important piece. Plus it's well written and accessible. I hope Joseph Stern, who is clearly a gifted writer, will write many more pieces and I hope his memoir reaches far and wide. This is an important story for everyone, especially, perhaps, other doctors and health care professionals whose manner can make or break a vulnerable person whether they be a patient or a family member. Bravo.
8
Yet another Doctor Who suddenly finds empathy when something hits him personally. This has become a very tired theme.
5
This isn't just an ongoing problem with doctors, we all have the opportunity to develop more empathy when a problem or tragedy occurs in our own life.
6
@JW
Yes, those do get tiresome. This one was probably the best I'd ever read and the first one where my takeaway wasn't "yah. wouldn't go to that doctor."
Many cancer patients will not have family to advocate for them. Their experiences will be very different from those described here.
8
You learned a new kind of compassion from your dying sister. It took courage on your part to admit that. Both you and Victoria deserve admiration.
7
Empathy will always find you as long as you're predisposed.
1
Thank you for describing the urge to run and what it means to be with someone.
5
Beautiful letter of love and humility.
10
Great article, Dr. Stern! You're an excellent surgeon, who genuinely cares about his patients. Your sister is proud.
8
I have often thought that doctors, particularly oncologists, develop a needed shell around their emotions, if not how could they possibly deal with so much loss? Dr. Stern, thank you for letting your shell crack and having the courage not to let it close again.
18
@Lisa Klepper Tannenbaum
Very true. My husband has been a heme/onc Dr for 37 years. He saves his tears for the privacy of home. He chokes up recounting the patients he has seen that day or when he listens to stories or movies= so as not to burden his patients with his emotions. They love him because they know he cares,
5
Cancer patients have to summon a courage many of us fear we ourselves could not. As a Radiologic Technologist, I have seen many Cancer patients from initial exams through therapy planning to post surgical exams for over 30 years and it still hit me when the patient was my own mom.
Her cancer was Multiple Myeloma and I was the family member who drove her to appointments, treatment and back and forth to the hospital. Despite having seem much of what goes on up close, it is different when it is family.
She was unable to tolerate the drugs used to treat her Myeloma because they aggravated her other medical conditions and she stopped the treatment- I quite clearly remember seeing her tell her Oncologist "I know what I am doing and where I am going" in a plain-spoken style. I also remember the Doctor tearfully talking to her about her decision.
She checked herself into a Hospice and did not want home hospice as she did not want her children to be burdened with caring for her and dealing with the rest of their lives and obligations. Like the author's sister, she quickly came to know the staff of the Nursing Home where the hospice was located and became friends with other patients despite the relatively short time frame.
I remember my last visit while she was still conscious and people were coming by to see her- staff, family and friends. She was praying for them as she lay dying in hospice, consoling them over what was to come. She was at peace with her faith and her fate.
28
@David Gregory
Your mother reminds me of what I learned from a book called "Being Mortal" by Atul Gawande. Your mother is exactly what the message Dr. Gawande writes of.
Thank you for your comment.
10
I'm very sorry for the author's loss, but as a patient (b/c), now in remission, I absolutely do not want my doctors crying with me or for me. My physicians and surgeons, taken together, conveyed an attitude of calm competency and sympathy for the plight of their patients, coupled with a firm awareness of what was and wasn't possible. I found this matter-of-factness to be very affirmative in the end. Maybe it has to do with the culture I live in, where traditionally life has been very tough and people tend to face their problems - including dying - with a certain amount of stoicism.
8
Thank you, Dr. Stern, for your tribute to your sister and for sharing your disorientation at not being able to use your doctor credentials as one of her physicians.
Eleven years after my father's death I still remember my disorientation from being unable to serve as the hospice chaplain for him and for our family. In retrospect I think our sick loved ones need us to be a loved one rather than another member of thier professional team.
May you now be able to choose the memories you want to cherish.
Retired hospice chaplain.
15
Thank you Dr. Stern for reminding us of
the challenges faced by people with
cancer, their loved ones,
physicians, nurses and caregivers.
Your sister’s spirit will always be with you,
a reminder of the pain and love you witnessed.
Let us be aware of the the challenges of a
caring physician and the need to be
empathetic human beings.
You set the bar high.
22
This is such a powerful, painful and beautiful read all at once!
My mother lived with the Sterns in Washington DC as a Nigerian college student in the 60s (during the Biafran War). She got married from their home. Caroline, Jody and Victoria (RIP) were flower girls and page boy at my parents wedding. Decades later, my husband and I lived with Elizabeth Buchanek (mom) for a few weeks before we got married.... This a family that defines love, family, charity and commitment through adversity, so Jody’s profound experience and the message this piece conveys isn’t terribly surprising. Know that my family will love you guys for EVER. Know also that Victoria rests x
54
My 2 cents as a physician. Dr. Stern appears to be a really good guy who happens to be a physician. I doubt the way he treats patients, performs and indicates surgeries changed since his episode with his sister. Whatever transformation came over him is in his own mind. A way to channel grief? He may have become a better person, just not a better physician.
21
Dr. Haar,
How could having greater empathy and emotional connection NOT make one a better physician? Perhaps you meant “technician” rather than “physician”?
But really, why would you, or any physician, stop and take the time to write such a comment? It only feeds the common belief that many physicians and surgeons are highly skilled, Type A “technicians” who suffer themselves from an inability to walk a mile in the shoes of their patients.
4
Victoria was my first girlfriend in 3rd grade! I asked her in a Valentines Day card whether she liked me and as she went to the water fountain she looked back at me and nodded. We spent that year sitting next to each other a lot and I specifically remember her beautiful long brown hair. She had a beautiful spirit and great creative energy. It was particularly difficult to read this article as I lost my mother at age 18 to cancer and share many of the confusing and inspiring feelings that Jody now feels. By chance, I saw Victoria's mother last week and it was a particularly bitter sweet reunion. Stay strong and my thoughts are with you and your family.
65
What a touching, touching article. Just beautiful. My thoughts remain with everyone in the article, and with Victoria's family.
16
Fantastic article, extremely thoughtful and artfully written. As a physician who has experienced loss, I feel like my experience has also made me more empathetic to the patient journey. I wish I had the eloquence that you have in expressing those feelings. Thank you.
23
What a beautiful, beautiful essay. You made me cry.
I wish you all the best, Dr. Stern, and I will look for your book, which I now feel eager to read.
Thank you.
22
Thank you Dr. Stern for sharing your love and testament to your lovely sister. My husband and I have been health care providers for over thirty years and understand your insights and compassion that now has thoroughly been given free reign with your patients.
10
All “good” doctors have grasped why they are called “attendings” - the first , ultimate, and often, last duty of a physician is simply to be present. Dont expect this realization , let alone actualization, from “interns”, “residents” or “fellows”....demand it from all your “attendings”....
17
@John Whitc As my own attendings used to say "we are all students of medicine." Growth in any profession is never-ending, and I have seen interns and residents who have served patients not just as their physicians but as a human being trying to provide support in any way possible. We all need to be reminded regularly about the humanity that every healthcare professional needs to embody (or else just hang it all up...)
16
John Whitec,
And I would say: “and attendings, make certain your residents and interns, understand the concept of being present by mentoring them with your presence.”
5
Thank you very much for writing this.
15
thanks for this Jody.
4
May her memory always be a blessing and a comfort to you and your patients, Dr. Stern.
15
I too have changed after the loss of my wife who coincidentally was also treated at City of Hope for much of her course. I am a specialist in pediatric intensive care and have learned much by sitting with my wife for her last month, which was spent in ICU. I too was not any longer a physician but merely the spouse. My normal role in the ICU, my second home was taken from me. Yet, I saw how my wife despite her enormous pain and discomfort still mustered the ability to treat each of the many caregivers with respect, also inquiring after their families and other aspects of their lives. I also saw the dedication of the many people she interacted with to give her a “good moment,” to at least make whatever time she had left to be as comfortable as possible. These were often the small things, repositioning a pillow or helping her to move, or merely a kind word. I have become much more concerned about how my patient’s parents and other family members are coping with the ultimate nightmare - their child is so sick or injured that they need intensive care. May the memory of my wife and his sister be for a blessing.
51
Thank you so much for writing this. You have helped put into words how I feel about being present with my brother during his treatment for stage IV modular melanoma at MD Anderson in Houston, it had moved as well to his lungs and liver; sadly his treatment didn’t delay the inevitable, but being with him as made me far more compassionately aware of others going through this.
18
Dr. Stern I am sorry for the loss of your sister but thank you for sharing such a moving story which brought tears to my eyes.
17
Thank you for this wonderful essay. Victoria was so fortunate that her brother is a brain surgeon, and luckier that he is a wonderful person. And you are so fortunate to have had such a huge hearted sister. Thank you for this essay and for all you did for her and all of her/your loving family, and all you continue to do.
18
Dr. Stern, Thank you for a very moving tribute to your late sister and to sibling love. Your sister gave you a great gift which in turn will enhance your work in every way--the courage to be loving and compassionate. I too recently was comforted by my very ill sibling and amazed at his acceptance and forbearance in the face of great challenges. He passed away, but I am forever changed.
21
I am so grateful that you re-connected so easily with Victoria and were able to give her the gift of normalcy in such a wildly un-normal setting. I know that you found great reserves of patience and let her lead the discussion. Allowing yourself to feel more fully is so important. Allowing the patient to guide you as you did for Victoria takes an amazing amount of strength and attentiveness.
19
I recognized the woman in the photo with the mask immediately. She shaved my husband’s hair-twice. I am sorry for your loss. You always think you are going to walk out of that room together,and better. Thank you for letting the world known how you learned from your experience, we wondered so often, do the doctors understand what it’s really like going through this ? Now I’m sorry that you do, but glad for your patients.
22
I've often wondered why doctors I've known (whom I believed to be good people) showed little or no humanity with patients. I've also wondered why gravely ill and terminal patients will undergo expensive and grueling treatments for little to no benefit, considering their big picture. I've wondered why good doctors will do what basically amounts to expensive torture or expensive time wasting at the end of a patient's life. Dr. Stern's full memoir, which was one of the most challenging and enlightening things I have ever read, answered all of those questions for me.
27
Like Victoria, I battled a diagnosis of leukemia. Why I got it and why I survived, I have no idea. It came out of nowhere, as cancer does. My leukemia was different, and required only a one-month hospital stay until my blood counts returned to normal. Eight months of outpatient treatment through a port placed under the skin of my chest followed. To say the experience was surrealistic is an understatement.
I feel such sadness for Victoria, her brother, family and friends. You think you can beat it, and sometimes you do. We all have that goal in mind but it’s not always in the grand plan. The possibility of losing is so difficult to grasp that it’s best to not even contemplate it. Better to receive and feel the love of all who surround you and soak it up. When else will you have the opportunity to witness your own funeral?
Victoria gave her brother the gift of a new set of eyes to see and feel the desperation of a patient facing an unfathomable future. It’s a beautiful thing to witness his embrace of that gift. I hope he never lets go.
43
@Commentary Thank you for sharing. Your witness was lovely. I wish you blue skies and sunflower days.
16
I have been quite ill recently and would have done almost anything for a doctor to be so kind to me. The lack of compassion at the hospital was breathtaking, literally.
45
A very moving remembrance and a blessing for Dr. Stern and his patients. I remember the words of my dear cousin of mine (since passed away too young from cancer). We were talking about the surprising emotional intensity we felt about our mothers (sisters) passing away, as mine had died several years before her mother passed away at age 99. She felt guilty she had not been more supportive of me. She said simply, "I did not know." The truth is most of us don't know until we come face-to-face with the mortality of loved ones. It takes courage and determination to live life differently once you "know."
41
Wonderful. My doctor has never held my hand, but I'll bet she would if I needed it. Makes all the difference in the world, just to feel that something like that is possible.
19
Thank you for writing such a touching tribute to your beautiful and brave sister. In 2013, I lost my beloved sister to a very aggressive form of lymphoma. She fought valiantly for two full years. And throughout her very painful and debilitating treatments, she always remained fearless and positive. While I have so much admiration for my sister’s amazing courage and strength, I also have considerable guilt about it because she had to be nothing short of superhuman when she was battling cancer. Anyway, I still miss her terribly and try to live my life in a way that honors her memory and legacy; however, I often feel that I fall short. Your essay reminds that I need to keep trying. Thank you, again.
33
two thoughts on this article: first it's sad that doctors routinely learn to suppress their humanity during training and practice; second there's no more effective way to regain it than being a patient (or a family member of a patient) but the latter still allows a degree of distance that the former denies.
9
You have written a touching, empathetic recount of your deep connection with your much missed sister. Thank you.
20
And I cried. Thank you, Dr. Joseph Stern.
9
The brutality of watching a loved one suffer and die can't be underestimated. The wound becomes part of who we are. We have to stretch ourselves to process and encompass it, it is that unthinkable.
In doing so, we gain a solidarity with all the suffering people of the world. That is the gift.
Thank you Dr. Stern, for talking about the hard-earned rewards of watching and assisting your beloved sister as she struggled with grace and dignity. I did the same with my dear brother.
I, like you, carry this with me always. It informs all I do.
62
@TM
Thank you for your comments. I did the same with my husband and I agree with everything you said.
2
Dear Dr Stern
Thank you so much for sharing this. I am a 76 year old physician. The professors in medical school told us to be stoical, detached and uninvolved. A family doctor had taught a frightened 10 year old only child that his single parent mother would be ok by taking time, comforting words and a kindly hand on the shoulder.
The professors’ words and examples went unheeded
With best regards
50
Thank you, Jody, for writing this. It sounded just like Toria. She was a dear friend and although I had not seen her for years, I always thought I would again. Thank you for caring for her and for bringing her back so vividly.
13
Thank you Dr. Stern. Your humanity is beautifully felt. It seems to me, a curse and a blessing, that such depths of understanding are so costly.
Peace, and thank you.
Paul
34
Thank you for your kind and thoughtful comments about your relationships while recognizing the realities of long and gruesome treatments
15
"every patient has a story" - we, as providers, need to remember to take time to listen to that story. See each patient as the person they are, with hopes, dreams and challenges. Then we can see how to serve them with their condition in a way that honors their personhood, their story.
@nuka @arbinger
7
Thank you for sharing your thoughts about your sister. Cancer is a terrible disease and it touches us all one day in one form or another. Gratitude is a wonderful feeling to have with the people in one's life and with the world outside. Gratitude for life and its preciousness.
4
Suc a moving description of your time with your sister and how it transformed you. Whenever doctors let their own experiences help them be better doctors, we all gain something.
This happened to me when my brother drowned six summers ago. I am a different psychotherapist now, especially when I am helping someone who is facing a major health crisis or a family or a friend's death.
29
These are the first words I read today and I am so thankful to you, Dr. Stern and am struck by the enduring love and affect your sister has had on you. My sister too remains and resonates deeply as a guiding force in my life, I hadn't expected that, we lost her a bit over a year ago from uterine leiomyosarcoma.
28
A beautiful story. Thanks for sharing.
When a doctor begins practice, it's a full time job just learning how to make a diagnosis and treat. If that doctor is a surgeon, it's a full time job learning the techniques. Doctors are never really taught the art of empathy. It comes with time. With experience. The best doctors seem to those who have experienced illness or loss in their families. Or they became patients themselves. When I say "best", I mean defined by the judgment of their patients and their families. Patients and their families are the ultimate arbiters of whether their doctors served them well.
48
Thank you for this beautiful story. I too lost a sister after a long protracted illness. Her courage and grace during that time have stayed with me as a lesson on what courage really means. Your sister has left a wonderful legacy.
22
Dr. Stern, thank you for being open and honest about what you learned. It helps us, the families of patients, to know that our loved ones' caregivers can empathize with us as we struggle, fighting the fight, rejoicing in our victories and grieving our losses.
14
Thank you for this wonderful essay that reflects so vividly the feelings and emotions of caregivers and loved ones of people who are seriously ill. Nothing prepares one for that journey, but to know that the result is increased compassion, understanding and humanity for others is such a comfort. Your words resonated with me as I continue to process the loss of my younger sister who passed after a long struggle to get to a double organ transplant, followed by a non-linear recovery. You reminded me that there were lasting gifts from what was a really tough period for her and for our family.
35
lovely tribute to your sister and what a gift she gave to you, that of empathy and compassion. glad you were able to reconnect in her lifetime.
24
I am a retired physician. I am also a widower having lost my wife to a glioblastoma in 2013. I found your story touching and beautiful.
91
Bless you, Dr. Stern. Many of us lay people are offended by doctors who, while protecting their hearts, seem to not care about their patients, only their duties. Obviously, a little humanity goes a long way.
46
What a beautiful story. I have faced cancer several times and so appreciate the thoughtfulness of my family and friends who have comforted me.
63