"We Treat, God Heals"
I was discussing last week about how tempting it is as a doctor to feel like it is the physicians who have the responsibility to bring cures and healing. From my training and my faith to my clinic motto: “We Treat, God Heals” – I know that even when I do my best, sometimes people will be healed and sometimes they will not. But as one who conscientiously wants to do my best, help people, and achieve goals, sometimes I carry burdens on my shoulder for a patient’s healing, even when only God can do the final step and make someone whole.
For example, last week a nurse brought her mother-in-law to see me. She had been sick for weeks and had already taken the strongest antibiotics available, but she continued to have fevers and feel unwell. Her vital signs were not great, she was badly ill, the type of illness that we give the red-flag of Systemic Inflammatory Response Syndrome; the type that we watch closely, treat aggressively, and try to find a source of infection and a cure. I gave her the strongest antibiotics we had, a renewed course. I checked for other infections and found something concerning in her urine. That earned the diagnosis of Urosepsis and an admission in the hospital. She got 3 liters of fluid and a couple doses of antibiotics and started to improve. Her full blood count was pretty concerning before she saw me, but on the day I saw her, the inflammatory cells were back to normal. With that value and her improvement on the second day, I was ready to promise her an early discharge and praise God for a miraculous healing. But then the full blood count on the third day showed an even worsening picture, so bad that the good-looking initial blood tests looked like an error (and probably were) in retrospect. We continued antibiotics, even though they might not fully help. We continued to give her fluids, although she was starting to get a little swollen in her feet. We drew cultures, trying to see if we could grow bacteria from her blood and urine. Recently there has been more and more antibiotic resistance in our communities, and for some patients there is no medication that would still work for their infections.
She had high sugars and signs of acid in her urine, which could be a complication of diabetic ketoacidosis or simply an indication of a bad infection and dehydration. We had an ultrasound of the kidneys and we knew that she was having kidney trouble, but we didn’t have fancy tests to know whether the problem was originating in the kidneys or elsewhere. We didn’t have the fancy blood tests to know if there was acid in her blood, which would lead us to treat her slightly differently. I kept feeling like we were missing something, I racked my brain for esoteric conditions I might have heard of in medical school a dozen years ago.
But in the end, we didn’t have the testing to know more about what was going on. We didn’t have the specialists to assist with a more complex diagnosis or the machines to help stabilize her more. I wanted to do more, but I was at my limit in this context. I worked closely with my colleagues, and we waited for the results of the blood culture. Finally we found the infection in her blood, and the right medication to treat it. She improved and was sent home after a week, longer than I would have hoped, but sooner than I had feared.
I have to admit, it was so hard for me to wait and not be able to do anything as she worsened or recovered in the hospital. As much as I pray for God to heal and as much as I trust the handover to my national colleagues, in practice, I still try to grab up control and still want to do something myself to push the healing to come sooner. Clearly I have a lot more to learn about what it means to treat and who truly beings the healing.