Where there’s a Will, there’s a way

by Jamo Rubin, MD

No one will ever accuse Will of being born with a silver spoon in his mouth. When Will was 6, his mother fled their abusive household leaving him and his three siblings behind. There were uncles and cousins in and out, and Will’s father would show up from time to time, but for the most part the kids raised themselves. None of them stayed in school. By the time he was 16, Will was on his own.

Will ultimately landed a job as a custodian at the local high school. He worked hard and felt good about his job; he was friendly, loved being around happy students, and had a good heart…sort of.

While waiting at the bus stop one evening after work, Will collapsed and was rushed to the hospital. He had suffered a heart attack at age 53.

The hospital was busy and short-staffed, but after a few days of tests, he was apparently ready to be “discharged”. “Good news!”, his nurse exclaimed, busily sorting his stack of discharge papers and instructions. “We’re letting you go home early. Let’s go through your discharge instructions.”

The nurse presented Will with discharge papers, release forms, and written instructions for follow up. She handed him three prescriptions, and asked if he had any questions. Ready to leave his plastic pillow behind, Will had no questions. But he had a secret.

Will could not read. He had quit school when his mother moved out. He tried to learn many times, but as he got older it got more difficult, and with each failed attempt his shame grew. Now he was being discharged with pages of written instructions that might as well have been written in another language.

While Will’s story may seem to be about health literacy, it’s really about vulnerability. And becoming vulnerable can happen to any of us. Imagine a vibrant healthy you sitting in a doctor’s office stunned to hear the word “cancer”. You begin to feel a sense of dread and think, wait…did he just say I have cancer? How much will you remember after that word? And more importantly, did your doctor understand your vulnerability and respond to you in a way that is most helpful … to you?

Being vulnerable is not limited to those experiencing social or financial hardships. Being vulnerable happens to all of us when illness strikes. Most of us can relate. We’ve either experienced or know someone who has been diagnosed with an illness that has changed the course of their life – even if for a few months. Within a matter of weeks, conversations begin to revolve around appointments, chemo, surgery, support groups, etc. Our priorities can change in an instant. It can feel uncomfortable and overwhelming as the veil that often masks our vulnerable soft spots is suddenly ripped and riddled with holes.

When we consider the Social Determinants of Health as obstacles to successful recovery, the world begins to look a little different. We’re able to feel what it’s like to be the one sleeping on a plastic pillow, we begin to imagine what it must be like to not be able to read. We evolve to becoming more empathic, present healers rather than rushed, distracted providers. And the “patients” we help are individuals just like Will, whose journey to a better outcome will be smoother and faster, at a lower cost, and most importantly involve helping hands to get them back to the life they want to live.

Will didn’t want to be in a position where his vulnerabilities were on display. He missed his job and seeing the students each day and they missed him. Will needed the assurance of providers who could connect with who he is and what his life is about. He didn’t need to be treated as ‘the heart in Room 423’, he needed to be treated as ‘Will who had a heart attack and is feeling scared’. Will needed connection and some helping hands to get back on his feet. And isn’t that the reason we got into this profession to begin with?