Sometimes it is only in the aftermath of death that we fully appreciate an individual’s effect on our lives. In 2006, my father-in-law, my mother, and the famed cardiac surgeon Norman Shumway all died. Predictably, my mother’s and father-in-law’s lives and their loss affected me deeply. Memories of my mother still trigger tears. What surprised me, though, when I reflected on Dr. Shumway’s death, was recognizing the influence he had on the way I care for my patients. As I sat down to write a comment in his online memorial book, my thoughts immediately returned to Sunday mornings at the hospital when Shumway made rounds.
By all accounts, Norman was gregarious, generous, brilliant, and funny. I gleaned that from countless anecdotes, memories, and stories I had read and heard. I did not know the man personally. That is why his impact on my behavior as an NP is so remarkable.
Immediately after college, I took a job as a staff nurse at Stanford Hospital in Palo Alto, California, in a unit combining an eight-bed intermediate ICU with beds for patients with less acute conditions. In 1974, men recovering from coronary artery bypass surgery occupied most of those beds. Shumway’s team operated on many of them, and on Sunday mornings he and his team did rounds. By then, Shumway was a renowned transplant surgeon (he performed the first successful human heart transplant in the United States), so the team wrote most of the orders, managed pain, and tracked patient fluid volumes, electrolytes, and cardiac rhythms.
When the chief himself arrived, his presence created excitement among the patients. He came striding in, posture erect, with gleaming white hair and a broad smile that lit up his eyes. He greeted every patient with that smile. Later, I recalled how he touched the foot of each man and pronounced, “Ah, you’re going to do fine!”
The patients beamed. They sat up and fairly floated. “Did you see him? That’s my surgeon,” they’d say to the man in the next bed. Then they settled back against the pillow with a glow of contentment and peace. Shumway’s affirmation and his touch did more for those patients than the narcotics we gave them for pain.
Frankly, I observed those Sunday morning rounds infrequently, as I was on a rotating schedule. In the year or so that I worked on the unit, I observed Shumway’s ritual fewer than 12 times. The esteemed surgeon did not even know my name.
I left the intermediate ICU to pursue my goal of working in women’s health. I oriented to labor and delivery and used my critical care nursing skills to care for high-risk pregnant women in the delivery room. Later, I went to graduate school to become a nurse practitioner in women’s health. As my practice evolved, I found myself touching my patients, usually on the arm or the shoulder, often as I handed them a requisition for a mammogram or a prescription. In parting, I would say something uplifting like, “That foot will heal soon” or “Your infection will respond to the medication in a day or two” or maybe just “Hang in there!” Is it my imagination, or did the women stand just a little straighter or step with a bit more spring as they left the office?
It was not until Shumway died that I remembered those Sunday morning gestures, the touch on the foot and the upbeat pronouncement.
Then, a few months later, a physician friend of mine mentioned that her mentor had died. At his memorial service his physician assistant gave a moving eulogy in which he described how the deceased doctor always touched his patients. My friend told me how the doctor’s doing so had influenced her own interactions with her patients. Instantly, the light bulb lit. It all fit together! I saw the connecting thread tied to my gesture of touching patients and leaving them with that upbeat affirmation. The thread, I finally realized, wound all the way back to Sunday mornings with Shumway.
Nancy L. Riffle recently left her position after working for 23 years in a women’s health private practice in Palo Alto, California.