Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!

Internal medicine physician Augusta Uwah discusses her article, “The dying man who gave me flowers changed how I see care.” She shares the emotional story of a terminally ill patient whose simple act of gratitude transformed her understanding of compassion, presence, and what it means to truly care. Augusta reflects on the challenges of patient care, the importance of listening, and the quiet moments that redefine medicine beyond treatment. Viewers will learn how empathy and presence can leave lasting impacts, even in the face of loss.

Our presenting sponsor is Microsoft Dragon Copilot.

Want to streamline your clinical documentation and take advantage of customizations that put you in control? What about the ability to surface information right at the point of care or automate tasks with just a click? Now, you can.

Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Offering an extensible AI workspace and a single, integrated platform, Dragon Copilot can help you unlock new levels of efficiency. Plus, it’s backed by a proven track record and decades of clinical expertise, and it’s part of Microsoft Cloud for Healthcare, built on a foundation of trust.

Ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow.

VISIT SPONSOR → https://aka.ms/kevinmd

SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast

RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome Augusta Uwah. She’s an internal medicine physician. Today’s KevinMD article is “The dying man who gave me flowers changed how I see care.” Augusta, welcome to the show.

Augusta Uwah: Thank you so much for having me, Kevin.

Kevin Pho: All right, let’s start by briefly sharing your story and then we’ll talk about your KevinMD article.

Augusta Uwah: My name is Augusta. I am an internal medicine physician. I trained in Washington DC, Howard University Hospital. I’ve been a hospitalist for about ten years now, mostly practicing in the Midwest. I have practiced a little bit in other states and also a little bit outside the country.

Kevin Pho: All right. You shared this story with us in your KevinMD article. For those who didn’t get a chance to read it, tell us what it’s about.

Augusta Uwah: The story came together. I wrote that article in about fifteen minutes after a really rough month at work. At the end of my ninth shift, the story is about a gentleman who had a brain tumor and was hospitalized.

Some patients who are hospitalized really cannot speak for themselves, and it is hard sometimes for us as physicians to see them, hear them, and understand them. This man was virtually dying. At the end of the day, I really could not do anything for him.

His tumor had recurred, and we were just looking at Hail Mary efforts. It was a bit of a struggle to get all the teams on board on what to do. In some hospitals, the burden of the care fell to the hospitalist. This patient needed a large multidisciplinary approach. Knowing that an internal medicine physician cannot really do much for a brain tumor except a bit of steroids, I decided to dig a little deeper into his background and get to know a little bit more about him, as I do for most of my patients.

At baseline, this man was thought to be altered and nonverbal, but I find that with a lot of patients we think are nonverbal, they can communicate. On trying to have a conversation with this man, I found out that all I needed to do was sit with him a little longer and give him the time to get his words out and what he needed.

I also had to think about what I could offer him as a human being. Sometimes you’ve reached the limits of your capacity as a physician. He was MPO; he’d been MPO for fourteen days. He had been eating prior to that, and he had some significant dysphagia.

We were considering a PEG tube placement. We had the conversation: “This may not be going where we needed to go, and while you’re not ready for hospice, what can I do to make your day or your stay better?”

One morning, he would always light up when I walked into his room because he knew that I was probably the only person he could have a conversation with, outside of one of his family members who came and spent a couple of hours a day. He said, “I would really love some coffee.” I said, “I think there’s a way we can make that happen for you.”

I thought, “If I was in the bed and I couldn’t eat and the only thing I wanted was coffee, just a taste, how would I make that happen?” I remember that the nurses have these little swab sticks that they use to swab the patient’s mouths. I talked to the nurses: “How about instead of putting it in ice or water, we put it in coffee so that this man can have a taste of coffee?”

He was so happy and so excited. We did that for a few consecutive days. Every day I’d see him, we would have a conversation. I found out he was not as altered as I thought he was. He was an advanced conversationalist. He asked me where I trained and wanted to know more about me and things like that.

Towards the end of my shift, I let him know I was going to be leaving. I was really surprised on that last day when I showed up and there were flowers at his bedside. I thought, “Wow, who’d you get flowers for? Who brought you flowers?” He said, “Oh, they’re for you.”

He said he wanted to really appreciate the time I took to make him feel human: to talk to him, to hear him, and to listen to his needs. That really touched me. I almost cried; it brought tears to my eyes.

Kevin Pho: Oh, that’s such a wonderful story, and it really shows how that extra effort that you took to dig a little bit deeper beneath the surface made the connection with that patient and opened up a whole new world between the communication that you had with him. He was just so appreciative that someone would take the time to do that.

Knowing how busy hospitalists are, I’m sure that your census is very high. What are some of the obstacles that prevent doctors in general from doing that? I’m sure you have a million things, you have a big checklist. You have to get to the next patient. How difficult is it sometimes to sit down and take that extra time and make that extra connection with patients?

Augusta Uwah: That’s a great question. I think as hospitalists, we have a lot on our minds. There are goal-oriented tasks. You have the multidisciplinary meetings, you have the discharges before 9:00 a.m., 10:00 a.m., or 11:00 a.m. depending on where you are working, you have the admissions. Then you actually have patient care.

You have to document and bill. We have a lot going on. We have interactions with the specialists, etc. It can be hard, but I feel that I tend to care a little more about people who really cannot speak up for themselves.

I used to have fun on the job because I would have the most interesting conversations with patients.

Folks would ask, “You guys actually talked about all of that, and how long did you spend?” I would say, “Maybe fifteen minutes.” I actually had a patient that pranked me; he was aphasic, and he took the time to prank me after three days because his family said, “He really likes you, so he pranked you.”

But it’s not really hard if you decide that you want to take the extra effort. For instance, you see a patient wearing a T-shirt or something by their bedside and you ask them about it. They’re always happy to have that slight distraction from what is hurting, after you’ve asked them about what’s hurting, how they are feeling today, or what’s going on.

Sometimes it’s as simple as asking, “What did you have for breakfast?” I would notice that some little old ladies would have oatmeal every day, and I’d say, “Oatmeal again today?” I feel like it boils down to really wanting to connect with the person as a human. That just makes all the difference.

Kevin Pho: And in this case, in the story that you told, this was a patient who literally could not speak up for himself. Do you ever find being so emotionally connected with patients, especially in cases like this, palliative care, end-of-life situations? Does that take an emotional toll on you?

Augusta Uwah: It has in recent times. I really did need to step back after this year. In the past, I had mostly positive interactions, but I was working in a neurosurgery ward, and a lot of these patients could not speak for themselves. I felt I had to be the one to speak up and stand in the gap for them and make sure they were being heard because they are often very overlooked, probably not intentionally, but maybe due to anchoring bias. This is how you met the patient; therefore, this is how you assume they always are.

This was not the first patient I had communicated with that other people had felt could not communicate. And yes, it can take an emotional toll, but this man really touched me because of his appreciation, not necessarily because of his situation. That was what blew me away.

Kevin Pho: Now, among your colleagues and when you talk to other physicians, how common is it that you’re doing what you’re doing? How common is it for physicians who do take that extra time to sit down, especially in patients who can’t express themselves or people assume that they have nothing to say? How common is it for a physician to sit down and try to uncover that hidden connection?

Augusta Uwah: I would say generally speaking, not very. Most people tend to leave it up to the nursing staff. Sometimes they are just as busy as we are and may not have the bandwidth. For the physicians, too, it may just be that they don’t have the bandwidth for it. It is not as common as I think the person on the other end would want it to be.

Kevin Pho: Now we have a lot of medical students and younger physicians and physicians in training who listen to this podcast. Tell me what kind of tips and advice can you share with them in terms of doing what you do and trying to look for a connection beneath the surface?

Augusta Uwah: That’s a great question. For medical students and physicians in training, it’s important to know that everything you do matters. Everything matters, and you want your interaction to come out positive. You want what you’re doing to make a positive impact on the person in front of you, because even the things we take for granted can be really life-changing to some people.

Kevin Pho: We’re talking to Augusta Uwah. She is an internal medicine physician. Her article is “The dying man who gave me flowers changed how I see care.” Now, this particular patient interaction, did it change you as a physician and if so, how?

Augusta Uwah: I would say I have always been this person. This is not the first appreciative patient I’ve had. It just reinforced the importance of being connected and being sensitive, especially to patients who really cannot speak up.

Kevin Pho: And I think it’s all the more important when we have so many obstacles, I’m sure in your daily workflow, that prevent doctors from making that connection. Everything is so metrics-based, numbers-based, and quantity-based, and that places a lot of priority away from making that connection that you told in your story.

Augusta Uwah: That’s correct.

Kevin Pho: All right, let’s end with some take-home messages that you want to leave with the KevinMD audience.

Augusta Uwah: Care about what you do.

Kevin Pho: Augusta, thank you so much for sharing your story, time and perspective. Thanks again for coming on the show.

Augusta Uwah: Thank you very much, Kevin, for having me.