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Writer's pictureJonathan Burns

The Otter and the Nurse


Not long ago, my family and I visited Montgomery Bay Aquarium. Before we left, I went to the gift shop with my son to pick out a souvenir. He picked out a sweatshirt and I got on line to make the purchase. An elderly woman got in line behind me and asked if this was in fact the line for checkout. I told her it was and noticed she was holding a stuffed otter. I told her I liked her otter, my attempt at making light-hearted small talk. She thanked me and then said it was for her grandson who was in a car accident and currently in a wheelchair. She said he really was not doing well but she hoped the stuffed otter would help him in some way. I stammered, “Yes, I think that will be… good for him.”

I was completely dumbfounded after the brief conversation. I had been having a very good day with my family at the aquarium and happy enough to talk with a stranger, only to have things completely change from what I expected. It dawned on me that this abrupt change was just that – abrupt. The change had come from out of the blue and I was humbled by it. It sounds trite, but life is like that – things can change quickly, when you least expect it.

A few days later, my father called to let me know that my grandmother’s fight with cancer had taken a turn for the worse. She had had surgery a few months ago and everyone in the family assumed it was taken care of. Now I was being told she is expected to live for only a few more weeks and I am planning a last-minute trip to visit her in southern California, essentially to say goodbye. An abrupt change that I hope to handle with composure.

My grandmother was a nurse. She always told me she wanted to be a physician but was strongly discouraged at the time due to gender discrimination. The dream always stuck with her and when I became a physician, it resonated strongly with her. We’ve had a strong bond ever since. She always asked me pointed questions about my training, my career, and the challenges and changes that were happening. I got the feeling she was living vicariously through me. Her eyes would light up when I described anatomy dissection, or my Grand Rounds presentation, or the new procedure I learned in my pain management fellowship. But more important was the support and love she gave me throughout my journey becoming and being a physician.

Abrupt changes and devastating news can rock you and change the landscape of your life. The people that are with you and the relationships you have built center you in those moments and provide context for how you handle them. The only constant is change. I think it is best to prepare for these moments in every capacity of our lives, most importantly in our relationships with others to weather the storm. There is a popular notion that leaders and those in charge do not rely on others in times of change and adapt independently but I think this is quite wrong. It is embracing change with diverse opinions, backgrounds, and experiences with the people that have supported you and are currently in the midst of it that make the organization strong enough to endure, and sometimes stronger as a result.

While my grandmother is not in the office or clinic with me as things change and we need to pivot on the latest CDC recommendation or business challenge, I know her energy and support are. I bring this perspective and appreciation with me to challenges and changes, abrupt or otherwise, and hope it imparts some grace with my actions and behaviors.

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