As my patient’s face slowly became visible on the computer screen, I smiled and waved to her. She waved back with vigor.
She was a Cuban housekeeper who arrived in Miami during the Mariel boatlift in 1980. Now in her mid-60s, she had recently been diagnosed with leukemia and endured a two-month hospitalization during which her bone marrow grudgingly entered a remission, following an onslaught of chemotherapy. She was now back to see me as an outpatient.
At all of her appointments, she wore chunky gold earrings and bright red lipstick as if declaring that neither cancer nor a requisite surgical mask begat by COVID would interfere with looking good outside of the house.
“Hola!” I shouted.
“Hola, doctor!”
“¿Cómo estás?” I asked.
“Bien, doctor. Bien. Y usted?” She wondered how I was doing, her eyes narrowing with concern.
It was yet another session with a patient via telemedicine amidst yet another wave of a recalcitrant viral pandemic. The two of us were separated by ethernet connections and a few miles of heavy traffic traversing Little Havana, Coconut Grove and Coral Gables.
Only this time, the examination tables were turned — she was in my clinic room, and I was at home.
After over two years of obsessive vigilance, avoiding dining indoors and being the sole customer to don an N95 mask at Home Depot, quadruple vaxxed and declining a calendar page of social invitations, I had tempted the infectious fates by attending my son’s college graduation. And the fates decided it was my destiny to catch COVID finally.
Fortunately, my illness was short-lived. But I couldn’t risk passing the virus to my vulnerable patients even if I no longer had symptoms. After talking it over with my nurse Anastasia, we decided it would be best if our patients kept their in-person appointments: all needed a check of their labs, and many would need treatment or blood transfusions. I would see them virtually on a laptop that was moved room-to-room.
Ana and I started the morning in our workroom, reviewing the patients we would see that day over Zoom. When it was time to see our first patient, she lifted me brusquely. As we left our office, I caught a fleeting glimpse of a chair back, the drop ceiling tiles as we walked down the hallway, a brown door. I felt helpless and out of control – like when I was injured following a cycling accident, being wheeled down a hospital corridor on a stretcher for my X-rays.
The door opened, and I heard Ana greet our patient and explain that I was home with COVID. The world then stopped abruptly as I was placed on a desktop, and my patient came into view. I imagined I looked like Max Headroom, the disembodied artificial intelligence character from the 1980s, doling out medical advice or witty quips, depending on the prompt. Or perhaps the Wizard of Oz, though I hoped it would be less frightening.
“Me siento bien,” I reassured my patient. And I did feel well, though my viral antigen test remained positive. “The COVID…” I trailed off, shrugging my shoulders. I could hear her tsk under her mask as she wagged a finger in my direction.
“¡Necesitas ser más cuidadoso!” she told me.
And I took to heart her gentle scolding about needing to be more careful. Because by this stage of her appointment our roles had reversed: I had become the patient, and this woman —who was in the throes of an epic battle with cancer — was offering advice to me.
The pattern continued throughout the day. Ana determined when patient visits started and ended, whisking me along from one appointment to the next. And patient after patient asked after my health, offered solace, and proffered medical wisdom, from recommendations for rest, to over-the-counter medicines or the occasional folk remedy.
Perhaps it was the change of settings that led to the reversal: My patients sat rigidly in the stark examination rooms, with requisite blood pressure cuffs and ophthalmoscopes on display, reinforcing medical authority, while I sat casually in my comfortable home office with a Chinese fan palm visible through the window behind me.
Or maybe, at that moment, and given the not terribly positive press COVID has received over the past two-plus years, I was viewed as being sicker than my patients with leukemia and thus deserving of being the recipient of health-related counsel rather than the purveyor.
But I think it’s much more likely that my patients — some of whom are terminal and facing their own mortality; others who are suffering through a multitude of side effects from their cancers or our treatments – my beautiful patients haven’t let cancer compromise that core of humanity that allows them to care deeply about the welfare of another human being, despite what they are living through. They wanted me to heal just as much as I hoped for the same for them.
“Te quiero, doctor!” My patient shouted at the end of our visit, blowing me kisses through her mask.
“Te quiero, Mama!” I shouted back, grateful to be cared for.
Mikkael A. Sekeres is a hematology-oncology physician and author of Drugs and the FDA: Safety, Efficacy, and the Public’s Trust.
Image credit: Shutterstock.com
