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Updated: Feb 22, 2021

Getting caught up on notes from the week and reflected on a difficult patient experience that I shared with a resident. For the context, was finishing up my final scheduled patient of the day and a handoff came across from one of our FM residents. As we often joke as BHCs, it was the handoff the universe knew was coming in at 4:56 PM. As I walked over to the nursing team and was informed of the patient, I realized this was a patient I had seen a few times over the past few years. Protecting PHI, let's just say it was one of those patients that pulls at your heart strings, a teenager that was struggling, hurting, and unfortunately indiscriminately implementing a behavior repertoire based on avoidance. There is little to no chance this patient would ever access traditional mental health services (it is a miracle they have accessed us as much as they have). As I talked to the resident, it was clear they were feeling the same pull on their spirit, not only for the patient but for the parents that were worried and scared about their teenager who was clearly struggling. We, myself, the resident, the parents, and most likely the teenager as well, felt a sense of hopelessness and fear about the path our minds were predicting would become a reality if things didn't change. And, we all also knew, change was not likely.

After the last discussion and planning with the patient and parents, ending with a tearful conversation with the father regarding his experience, the resident, nurse, and I talked and debrief. The story, unbeknown to me, hit home for the resident on multiple levels. In a moment of unexpected vulnerability, associated with not only the current patient experience but a tiring year filled with death and long-hours, we all sat with each other. Not saying much other than acknowledging each other's humanity and what was present, as well as pondering, "what would we have done if we didn't have each other to rely on in moments like this?"

Clearly, the moment stayed throughout the weekend and after finishing up the documentation today, was able to reach out to the resident. We expressed gratitude for each other, as well as recognized the experience was still weighing on us both. Even through TEAMs/text messages, we held the experience with compassion and grace, together.

Writing this, my mind still is not hopeful on a successful outcome with the patient, which weighs heavy on the spirit. And, the gratitude and appreciation for not only the resident for initiating the handoff but for being vulnerable with their own humanity, which allowed me to be vulnerable with mine. The gratitude and appreciation for being in a job that allows us to access patients and families immediately, most often in their darkest hour. The gratitude and appreciation for being in a context and frame work (i.e., PCBH) that allows a value/mission to be realized while "leaning in" rather than "leaning out." The gratitude and appreciation for being a team, not only during clinical situations but after and between them so that we can hold these difficult experiences together. The gratitude and appreciation for being able to share this with this community, knowing that while unique, it is a common experience amongst the group. Indeed, the gratitude and appreciation for stories of PCBH like these... again, thank you for being here, it is healing...

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