Did You Hear That?

Do You Hear That? Was the topic at services this Sunday. Working in the Emergency Department, I hear and address a lot of medical complaints. However, since I recently missed diagnosing a premature rupture of the membranes in a pregnant woman, I fully admit I did not hear that being the major point of her visit. Her chief complaint was noted as vaginal discharge which typically connotes an infectious etiology. However, when a pregnant woman with the equivalent of a water balloon in her abdomen feels as though she wet herself, I can hear that concern about amniotic fluid possibly leaking. Did she hear that and did she hear her say that over listening to some one-sided conversation about me treating her for an infection?

I am often challenged by patients circumventing the exact point of their visit.  “I have abdominal pain with nausea and vomiting, chest pain, a headache and a blister on my foot. I just thought you would want to know everything.” What most concerns me is whatever concerns the patient. However, when patients have a multitude of concerns, I prefer they reach the point so I hear that. The culminating point is where certainty creates satisfaction and perhaps fulfillment. Many patients who present at the ED with the chief complaint of chest pain need to be certain that nothing is wrong with their heart. I hear that. Certainty can be established through a heart catherization or by reducing the risk factors and stress that may be contributing to heart disease. Satisfaction through what we hear regarding certainty is a personal and purposeful perspective and responsibility.

When it comes to the point that life is less than certain and death is imminent, do you hear that? What would be the purpose of prolonging your life? Would you be able to say “no” to that? From a purposeful perspective and larger responsibility, we could ask, “What is the point of your life? Do you hear that so others may gain an appreciation of your calling? Could you say something that emphasizes your certainty of personal fulfillment in order that others can hear that over a desire to prolong your life? I cannot listen to the radio today without hearing the lyrical plea, “Say something, I’m giving up on you.” Giving up on people occurs in no-win situations; no-win situations prolong the process of dying. Do you hear that? When considering an Advance Care Directive, say something that I could hear that supports your calling in life that permits dying.