”Do No Harm” – The Doctors Oath

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“Do No Harm” – The Doctors Oath, is brought to us by Libbie Goldstein. Libbie, 37, is married to Robbie Goldstein (born in London) and a mother of four. Libbie has been a maternity ward nurse in Hadassah Ein Kerem since 2006, following her Mother who was a midwife at the Hadassah medical centre for forty years. Libbie knows the Hadassah Medical Centre in and out, born in Hadassah and having received there three years of cancer treatments.

Since her recovery Libbie has put efforts and time in teaching medical professionals her life experience and knowledge. Libbie is currently at home on Maternity leave enjoying the family’s new twins.

Two years ago, starting a morning shift on the maternity ward, I was told that during that night a mother and her baby were admitted from the delivery room. I was informed that this young patient had, one week before, received a diagnosis of Hodgkin’s Lymphoma Cancer. The bells rang – this was the same diagnosis that I had received during my pregnancy with my second daughter.

(Hello, G-d?! can you hear me?!… I made a deal with you that I would be the last one to go through this! What happened to our deal?!)

At the entrance to our ward there is a fire resilient door, big and heavy.

I always imagine that my fellow staff members leave lots of hypothetical things behind that door. Was it the argument they had in the morning with their partner, or the unpleasant comment someone said to them in the carpark?

We learn to breathe in deeply and leave everything else behind before entering our shift.

When a medical professional enters the ward it is on him or her to set aside their personal beliefs and values – and don scrubs which represent a range of professional rules and values.

Our scrubs represent so much more than just a uniform. Obviously, it all depends how each one chooses to wear them. Personally, when I put on my scrubs I’m still the same Libbie. I don’t separate my personal life from my professional life a complete hundred percent. As for this there is a good reason. In the back pocket of my scrubs I carry my life’s experiences. Which are piece by piece a part of who I am today. And in no way can I or will I part from all of that.

Back to that morning shift…

In the corridor I meet the new Grandmother, the Mother of the patient I was told about earlier that morning. The staff on the night shift had already informed the Grandmother that there was a nurse who had the same diagnosis during her own pregnancy and now thankfully was a cancer survivor.

“Please speak to my daughter”, she approaches me.

And then comes the constant deliberation.

Should I share my personal medical history with the patients and how much to share? Is it at all professional? Will it be too much for her?

Or G-d forbid, could it do damage?

I open the door to the patient’s room and introduce myself.

I ask her permission to sit down and inquire how she is doing. She cries and I listen. I sit by her side in silence. I take a deep look into her eyes. Checking with her if it’s appropriate to hold her hand.

She asks a lot of questions. Questions that I myself asked a few years ago.

I’m not sure if now is the right time to share my story?

“I’ve been down that road myself and now thankfully I’m a cancer survivor”, I say with caution.

“What? Really?!” She asks and carries on.

“How old is your child today?” “Wow! You too have a girl!”

And then she asks the most common question…

“Is she healthy? Your baby girl?”

“Yes. Yes. Thank G-d. A healthy, beautiful, funny and clever child.”

I feel like I’m able to give her some comfort by this piece of personal information.

“Did the doctors let you breastfeed her? Because I really want to breastfeed”, she says.

“Even just once.

But they weren’t sure if they are allowed to let me…” she shares in pain.

I can feel her pain and identify with her request.

‘Just once’.

Please, let me give my child the best that I can.

Even if it’s just once… Such a painful memory.

But wait…her situation is different to mine.

I had to receive chemotherapy already during my pregnancy in order to save my life and my baby’s life. But this patient has yet to receive any chemical treatments into her body. And she so much wants to nurse her baby. So what exactly is the problem here?

“Wait here. I’ll clarify some things and get back to you”, I say to her.

Her haematologist, coincidentally also mine, is on his morning rounds and still unavailable. I make a phone call to the nurse in haematology to understand this patient’s treatment plan.

“You have to understand”, the nurse says to me, “emotionally it will be very hard for her to stop nursing in a weeks time when she begins treatment. So we thought that maybe it would be best if she does not start nursing at all…”

I need a minute to breathe.

A rush of heat passes through my body.

It brings up painful personal memories.

“Listen”, I say to her assertively.

“I went through this myself.

And I would have done ANYTHING to have nursed my baby, even just once!

But let’s put me and my history aside”.

“Here” I say to the nurse “we have a new Mother explicitly telling us she wishes to feed,

Whilst she fully understands that it may be at best temporary. So please tell me who are we to deny her this request?!”

I finish the conversation with the nurse from Haematology, pondering who has put us in a position to judge or make life decisions for those who come to us for treatment and trust us…

I dial through again to my haematologist.

“Libbie, is everything ok?” He asks in concern.

I tell him it’s important, but he shouldn’t worry for me, as this time it isn’t a Doctor-Patient conversation. For this conversation we are colleagues. I feel his relief and we both take a minute to appreciate the moment.

And then immediately we return to our roles. Doctor and nurse.

“Yes. It’s not a problem. The patient may nurse until next week”. The haematologist decides.

“When she starts chemotherapy she will have to stop nursing.

But please consult with the gynaecologist too”.

I make a quick call to the gynaecologist on duty who gives the same answer.

“Just check with a lactation feeding consultant”. The gynaecologist requests.

A minute later I have the most experienced lactation consultant on the line. She too agrees it’s no problem to nurse. Next week we will deal with the future.

I make one final call to the nurse in haematology to update her what was agreed upon between the different parties. I explain that it will be crucial next week to talk the patient through what lies ahead generally and in particularly the feeding before her chemotherapy begins.

This ping pong of conversations and inquiries are totally part of my job as a nurse. We don’t just carry out doctor’s instructions and giving out medicines. We don’t just give professional treatments.

Above all we have to make sure to do no harm.

And sometimes, when harm has been done, we nurses need to fix what was done beforehand…

I accompany the “new Mum” to the nursery. There her baby is connected to a monitor. I sit her in an armchair. Place the baby on her. And within a few minutes the baby latches on so naturally.

I watch over them both with a smile and a tear. In the midst of painful emotional storm, a new mother receives a peaceful moment of pure happiness.

Even if it’s temporary. I’m full of gratitude for this moment.

A moment I feel that I actually fought for my patient’s needs, for something that was truly important to her.

Maybe, because of my own experience.

Maybe because I feel so deeply that this is my calling…

And I pray to say the right words and to do the right thing. Not to add unnecessary pain to what this patient is already carrying in her heart. And somehow, in this moment, I succeeded to help a new mother and baby connect.

And I suddenly feel my own wounded heart and memories healing little by little.
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