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A Piece of My Mind
February 2, 2021

The In-between

Author Affiliations
  • 1Johns Hopkins University School of Medicine, Department of Medicine, Division of Geriatric Medicine & Gerontology, Baltimore, Maryland
JAMA. 2021;325(5):435-436. doi:10.1001/jama.2020.25885

I watched her small body move in and out of the magnetic resonance imaging (MRI) scanner, the machine clanging and chirping overhead. A hospital blanket lay draped across my shoulders, an untouched magazine in my lap. I felt the warmth of my husband’s presence next to me as I avoided making eye contact, pretending everything would be okay. Our bright, inquisitive 8-year-old daughter had been having headaches for several months. Working with our pediatrician, we had identified triggers and tried to change the pattern but in the weeks prior to the MRI, the headaches became more frequent and started to wake her at night. I tried to convince myself that we were overreacting, but as physicians, we knew her symptoms were concerning.

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    6 Comments for this article
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    Bless Your Family
    Andrew Gallan, PhD | Florida Atlantic University
    I pray for the best for your daughter and your family. What you have experienced and what you will experience is something I've never had to experience, but I feel your emotions in your writing. May God bless your daughter, your family, and her physicians, nurses, and all other professionals caring for her.
    CONFLICT OF INTEREST: None Reported
    Beautifully Written
    Paul Joannides, Psy.D. | Self
    This was beautifully written. I can only hope it will become required reading for medical residents of all disciplines.

    Decades ago, while in training, I spent a year doing play therapy with children undergoing experimental treatment for neuroblastoma and other brain cancers. To this day, I can still remember the pain in the eyes of the parents. It was indescribable and deep. I knew how to allow each child to use me in whatever way she or he needed, but I had absolutely no idea how to help the parents.

    Best wishes to you, your husband, and your
    daughter and son.
    CONFLICT OF INTEREST: None Reported
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    Godspeed
    Ilyssa Golding, MD MPH |
    This essay affected me profoundly. Your eloquence, grace and courage will see you through the days ahead. Your sensitivity will enable you to experience fully that which all those involved in your daughter's care can offer you. And you will undoubtedly set an example for both patients and medical personnel that they will not soon forget. I wish you, your husband, and your children peace.
    CONFLICT OF INTEREST: None Reported
    Personal Feelings
    Karl Stecher, AB Harvard, MD Maryland | Retired neurosurgeon
    The story was presented, or walked through, very well, so that we could experience your emotions. I hope the result was good, as some childhood tumors can have somewhat satisfactory results.

    But as a physician, I would like to learn more. What type of tumor was it? Results of the operation? How is she doing now? (And, for myself, who did the surgery?)

    And thank you for noting the nervousness of the doctor who had to break the news to you. You know, from your own experience, that we must steel ourselves
    each time we do this, or we would emotionally crumble with every patient. There is little understanding of this by the public
    CONFLICT OF INTEREST: None Reported
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    Mama, A Nurse
    Bogumila Snopek, Magister | Uniwersytecki Szpital Kliniczny
    Beautifully written. I am with you in my thoughts and heart. In Poland, in many specialties, I unfortunately miss such an ordinary, human approach to a sick patient. Especially in intensive care units, I lack subjectivity, especially in caring for an unconscious patient. I try to not run out of competences and qualifications as well as empathy during my work.

    Professor Rybicki was guided by the principle: do not forget. that you too can be in this sick man's shoes.

    (Original submitted in Polish; translation by Google Translate)
    CONFLICT OF INTEREST: None Reported
    Thank You For Your Essay
    Samuel Blackman, MD, PhD | Day One Biopharmaceuticals
    Thank you for sharing this deeply personal, and deeply affecting essay. I am a pediatric neuro-oncologist by training, and so your essay took me right back to the hospital where I did my fellowship, and those very hard conversations with parents of a newly-diagnosed child.

    There are so many dimensions to comment on here, but I wanted to thank you for putting into words the parent perspective of a child being diagnosed with a serious medical condition - especially those first moments. You confirmed something I learned during my first weeks of fellowship, and after: parents of children diagnosed
    with cancer (or other serious and life-threatening conditions) remember every moment and every word.

    Your essay is an important reminder to all healthcare providers - from physicians to nurses to technicians - that every interaction we have is a deeply human interaction, many of which will stay with people for the rest of their lives. We should all recognize the immense and lasting effect of our words and our actions - both big and small - when we dedicate our lives to the care of others.

    My very best to you and your family. And thank you again for sharing this private part of your life.
    CONFLICT OF INTEREST: Founder and CMO of Day One Biopharmaceuticals
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