say you're sorry

Ms. L looked good. Well, better at least. Still using oxygen. Still unable to stand from the wheelchair. Still in constant pain. But better than I’d seen her look since before last summer happened. Less shortness of breath. No more dizziness. Much more happiness. She had transitioned back to doing peritoneal dialysis at home for two weeks now. Her daughter providing even more care than she was before last summer happened. Lifting. Turning. Cleaning. As if it was her turn to be the mother.

I sat down with them to talk about the usual. The blood test results. What pills she was taking and when. What dialysis fluids she was using at home. How much fluid was coming out. I shuffled the papers littered with these data before my eyes, but my mind was distracted. Say it, I commanded myself. Say it out loud. Say you’re sorry.

“I owe you an apology,” I said, my voice strong as I looked her in the eyes, then her daughter’s. “I should have thought to get you home sooner.”

Ms. L's forehead wrinkled in surprise. The nurse at the computer to my right said nothing, but there was slight hitch in her typing flow. The daughter’s face pinkened from her seat behind her mother’s wheelchair. Her eyes went from me to her.

“No, no you don’t,” Ms. L said, as if it was her turn to take care of me. “I’ve been home.”

“I mean doing dialysis at home,” I said, my voice feeling shaky now. “I should have thought of it as soon as the rehab center sent you home….Sometimes we doctors get stuck on doing things like we have been and forget that we can change the plan. And for that, I'm sorry." I could feel my eyes begin to glisten. Don’t cry. Don’t cry, I commanded again.

“It’s alright. I’m home now and I’m doing better,” she said without pause. And with that I was forgiven as if there was nothing to forgive in the first place.

I looked away, up and to the left. Someone once told me this was a trick to stop the tears from coming. It worked and I went back to the papers in front of me.

Some might call it something close to courageous of me to admit I was wrong. To apologize. We doctors struggle with saying our mistakes and the sorries for them to patients and each other. Many would have said nothing or even disappeared from the patient’s life as did one of Robert’s (ALERT: shameless book teaser). One gets to be a doctor by doing well on tests. And ain’t nothing like this on any of the tests I took.

But no banners for me, though. Because even though the guilt did drive me to apologize, it wasn’t enough to make me tell her the real reason behind my mistake. What can I say; I’m just a doctor.