Back in med school in Leipzig, I used to work part-time as a nursing assistant on the med-surg floors. The money was good and one also learnt quite a bit about patient care.

In the evenings, I got to give the patients dinner and coffee. After that, I went through all the rooms collecting the coffee cups, plates and cutlery. One evening, I noticed I was short of several coffee cups so I had to go through all the patients rooms looking for the missing cups.

A coffee cup is “Tasse” in German and the term “..nicht alle tassen in Schrank haben” translates literally “..not having all the cups in the cupboard” but it’s a saying used to describe someone with a screw loose somewhere in the head – a nutcase!

So I march into the first room and blurt out: “Habe ich hier eine Tasse vergessen? (Did I leave a coffee cup here?) Ich habe nichts alle Tassen im Schrank!”

You could have heard the laughter miles away!

Many years ago, to supplement my income, I worked part-time as a home health caregiver.  One of the patients I took care of was a 93-year-old woman who never married and had no kids. She was once a very successful attorney but when I met her, she was a cold, bitter old woman who was dying alone. She had a nephew who visited every blue moon.

In sharp contrast to that was another one of my clients who was also in her 90′s but had children. I provided care on those days that her kids could not. She was loved and cared for and was one pleasant person.

I also had a couple who had been married for over 50 years. The man was  recovering from a stroke and the wife had her hands. However, the love that they shared was so evident and palpable, it was always a pleasure to walk into that home.

During this period, I got to thinking about the differences and pondered the essence of family. I wondered about the importance of marriage and children and came to a realization which has really impacted me since. The importance of marriage and children is seen when one is old.In those frail times, your loved ones provide that support.

Must one wait till one is 90 to see the importance of family? I cannot recount the number of times I have seen patients show up for major surgery in the hospital with no family – maybe a distant nephew or cousin miles away. There is a certain sadness that hangs about them in these times, especially evident when you see other families with tons of family members. Maybe marriage and kids are important at times of sickness too.

I am married now with 2 little kids and sometimes it feels like an unbearable chore taking care of them. Keeping a marriage going is no walk in the park either. In those times, I think of my clients back then and the lonely patients and keep going with a smile on my face.

I may have written a post about this issue before. Anyway, if so, here we go again….

Loosing a patient is very traumatic. It happens to every doctor and it is a pipe dream to think it would never happen to you.  It is a fact that some specialties are less prone to experience it than others. However, when it does happen, most physicians have no one to talk to. Fellow physicians are the worst group of people to seek solace from. The majority have their own professional and personal issues. Then is the judgmental bit – “If you had done A instead of B, maybe…” Which leaves our significant others, the majority of whom have already been overburdened with medical talk to the point where they are insensitive and frankly do not care anymore.

Would it not be great it there was “Vent” for physicians. 1-800-VENT! You call and talk anonymously to a listening ear about the death you had in the OR. About the fact that the team did all it could. About the fact that the patient had undiagnosed SAM or carcinoid or cirrhosis! About the fact that you were in the OR for 15 hours. About the fact that you bonded with the patient and his wife gave you a hug and his kids shook your hand. About the fact that the malignancy was inoperable. About all those things we are supposed to keep inside because we are supermen but really aren’t.

What if…?