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Opinion

Bearing Witness

4.17.19

For the May-June 2019 issue, Harvard Magazine associate editor Lydialyle Gibson profiled Rafael Campo, M.D. ’92, a poet and physician whose approach to caregiving prompted a personal reflection on the role of empathy in medicine and on her own family’s experience with a Harvard-trained caregiver during the death of a loved one.

~The Editors

 

Christopher Henderson, M.D. ’16, came to us during what turned out to be the last two and a half weeks of my father’s life. It was a period in which almost everything had become a bewilderment. Not quite a year earlier, my dad had been diagnosed with lymphoma and undergone a six-month course of chemotherapy that seemed both remarkably mild—he felt good and ate well—and miraculously successful. When the follow-up scans showed no lingering trace of the disease, we all ­exhaled. But a few months later, in late January 2017, the cancer returned, and this time the chemotherapy was harsher. And in the end, it didn’t work—when the new set of test results came back, during a mid March office visit with the oncologist, whose normal joviality had suddenly collapsed into chagrin, he transferred my father straight from the clinic to the inpatient cancer ward at Duke Medical Center, where that same afternoon, while my mother rushed home to pack a suitcase she hadn’t known she’d need, the medical staff started my father on a new, stronger round of treatment. 

Henderson was an intern that year at the hospital, and at some point not long after my parents settled in, he began stopping by my father’s room to chat. These visits were separate from the more formal interactions, when members of the medical team, Henderson often among them, would arrive in a cluster of white coats to examine my father or explain a new reading or talk about next steps in the treatment plan. When Henderson dropped by on his own, he’d smile and lean against the wall opposite my father’s bed, and for a few minutes he would just talk—or listen. We kept waiting for him to tell us the real reason why he was there, what he needed from us, until gradually it became clear that there was no real reason. The visit was the reason.

Henderson and my dad talked about all kinds of things. Doctoring, for one. Until he got sick, my father had been a pediatrician in the small town where I grew up, and one satisfying responsibility over the years had been shepherding young doctors like Henderson through training rotations in his office. Also, the two of them had both been in the military: my father in the army following medical school, stationed in Okinawa after Vietnam ended; and Henderson in the air force for eight years after graduate school, serving in Iraq and Afghanistan and South Korea, before deciding, on the threshold of 30, to become a doctor. They talked about family and home and hobbies, and places they’d seen in the world. They talked about music—my dad was an ardent amateur violinist and fiddler, and he’d asked my mom to bring his instrument from home, in case he felt like playing it while he was in the hospital. Day after day, though, it stayed in its case on the floor beside his bed, conspicuously inert, for the first time in forever.

My father felt so tired and weak during that time. He slept a lot, ate very little, and took short, effortful field trips to the enclosed sunlit patio on the ground floor. But the visits with Henderson seemed to buoy him, and they buoyed the rest of us too, my mother and my sister and me. The stories we told became a kind of escape, if only a slight one, to someplace else, to sometime before. To something more whole. I remember feeling frustrated that all the people we met—doctors, nurses, residents, who cared for my father lovingly—were missing the fullness of his warmth and humor. They couldn’t know how joyful a person he was. Somehow, his connection with Henderson felt like a restoration; it made the fullness visible again. One day my dad shared with him his list of favorite books, a carefully curated 16-page document that included titles on Civil War-era surgery, Renaissance art, Irish music, a history of dueling, neuroscience, astronomy, the modern Gregorian calendar, the Hundred Years War, plus the names of more than two dozen novelists. The next day, Henderson appeared at the door holding one of the books from the list, Oliver Sacks’s Musicophilia. He asked my father to inscribe it.

I remember learning in one of those conversations that Henderson had gone to medical school at Harvard. It was kind of an odd coincidence, running into him there, under those circumstances, but I didn’t think much about it beyond that. And then this past winter, I started working on a profile about poet and physician, and Harvard Medical School professor, Rafael Campo, M.D. ’92.

  

Previously, I had known Campo only through his poetry—although that by itself is a lot. His poems open themselves up to readers, with vivid, affecting stories about the work and worries of doctors, and the lives and deaths of their patients. Read a poem like “What I Would Give,” and you can feel the ache rising in your chest from the very first line—“What I would like to give them for a change / is not the usual prescription.” Or, in “What the Body Told,” the bracing thwack of those two opening sentences—“Not long ago, I studied medicine. / It was terrible, what the body told”—leading, eventually, to the symmetry and release in the poem’s close, the other half of a heavy truth: “Each nameless cell contributing its needs. / It was fabulous, what the body told.” Campo’s writing is tender and empathetic, but it’s also unflinching: he gazes at things that are difficult to witness—blood and pain, tragedy and injustice—and finds not only suffering, but love and grace, even beauty. As one colleague of his told me over the phone: “Rafael manages not to look away.”

Still, it wasn’t until I sat down with him to ask about his daily work at Beth Israel Deaconess Medical Center, and his philosophy of how to care for the patients he sees there, that I began to imagine what it might be like to be one of them. Campo talked about sharing stories with his patients—theirs, but also his. He talked about being open and vulnerable in the exam room, about putting his whole heart into his work, about letting its emotions reach him. He explained the difference between healing and curing, and how one can be possible even in the absence of the other. Listening to Campo, I started to feel like I was remembering something. I kept picturing Henderson and my father.

And so, on a Saturday afternoon a few weeks ago, I called Henderson up. It was the first time we’d spoken in two years, but he remembered everything: the music, the military, the discussions about doctoring. “Ah, the Gibson family,” he said. He was still working his way through my father’s list of books. Now a third-year resident at Duke, he has seen many, many more patients since we last encountered him. I wanted to know about his conception of empathy and care-giving, how he thought about his connection to patients like my dad. “Each person comes to you with different needs and concerns, different medical problems,” he said. “And as physicians, we’re charged with the responsibility, but I think also the blessing, of being with people at vulnerable moments in life. And often you are able to not only try to diagnose and treat them, but you also get a moment where you can exchange a piece of your mutual stories. You can get to know someone, and see how this moment might be nested within the greater arc of their life. It’s that human connection that is the best part of being a physician, the most soulful and enriching.”

He broke off. “That’s lofty-sounding, I know,” he said. But it wasn’t, really—it sounded just the way I remembered everything from two years ago. And it reminded me of something I’d heard recently from a fourth-year Harvard medical student, Robert Weatherford, who studied under Campo and spent a year seeing patients with him once a week at his clinic. One thing that experience had taught him, Weatherford said, was how much “patients need a physician who thinks about their lives as a story.”

Henderson, too, attended some of Campo’s lectures during his time at Harvard, though two other professors, Beverly Woo and Kate Treadway, were closer mentors. Still, the similarities between his practice and Campo’s are striking. “I remember patients who have gotten a lot better,” Henderson told me on the phone, “and then sometimes a person has a condition that’s just not going to move much, but you can tell that somehow healing goes on anyway. I love that.”

  

 On the night my father died, Henderson was with him. So was one of the nurses from the ward, a man who had spent countless hours at his bedside in those disorienting weeks. It had been a very long day. In the morning, my dad had decided to stop treatment, and so the doctors and nurses made him comfortable, and my mother and my sister and I sat down next to him to wait. We held his hand as he slept and watched his chest rise and fall. Outside the room, other loved ones began arriving. Sometime after midnight, my sister and I went to the hotel across the street to get a few hours’ rest; after a while, my mother followed. And then about 20 minutes later, her cell phone rang. It was Henderson.

My memory of the next several hours is mostly just fragments: the three of us getting dressed in a daze, suddenly out of reach of ourselves; shuffling wordlessly back to the hospital, across the dark, gaping stillness of the empty street; riding the sluggish elevator to the ninth floor. When we arrived at my father’s room, Henderson met us at the door.

On the phone a few weeks ago, he recalled that moment, too. “Part of being a doctor or nurse—or anyone in health care—is that in some parts of the system, you bring new life into the world,” he said. “And I think it’s also important that nobody leaves the world by themselves.”

He paused. “So, your father wasn’t alone when he died.”

“I know,” I said. Neither were we.

 

 

 

 

 

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