A Tumor Rupture That Turned Everything a Doctor Knew Upside Down

Every doctor becomes a patient at some point. For many physicians, a serious illness and the treatment process bring a profound transformation: they foster humility, offer a new perspective, and ultimately lead doctors to practice their profession with a different awareness.

Here is Dr. Rana L. Awdish's story, in her own words:

I was seven months pregnant, and it was the last day of my specialty training. I went out to dinner with my best friend to celebrate. At the dinner table, I suddenly developed unbearable abdominal pain and had to go to the hospital urgently. I did not know it yet, but I had a noncancerous tumor in my liver, and it had ruptured.

When I reached the emergency department, the security guard directed me to the maternity unit rather than the trauma center because I was pregnant. At that moment, I knew that what I actually needed was a level-one trauma center. But I did not advocate for myself. Although I was a doctor at that hospital, I realized how quickly you can lose control when you are a patient. In a crisis, you obey what authority figures tell you without question.

A resident doctor met me in the maternity unit. But he did not know how to use the ultrasound machine. At that moment, I saw the uncertainty of someone who was within medicine but could not find his place in it.

He looked at me and said these words:

"Honestly, I am not very good at reading these."

"I can read an ultrasound," I said.

I had to be the one to say that my baby had no heartbeat.

The resident asked, "Can you show me where you see that?"

In that moment, I understood once again that we see patients simply as learning opportunities. We look at their experiences from a different perspective, seeking to benefit from their trauma.

From that point on, everything went wrong. I was taken for emergency surgery. My hemoglobin level was 3. My platelet count was 15. My liver enzymes had reached the tens of thousands. I developed refractory hemorrhagic shock and multiple organ failure.

But that first hospital admission was not the last. What happened that night set off countless operations, readmissions, and stays in the intensive care unit. And my education continued.

I was not merely going through physical recovery; I also had to rethink my entire understanding of what medicine is.

I saw firsthand that we physicians are not prepared to face suffering. It is easy to see patients on a computer screen, neatly organized as data; the patient lying in a bed, however, is chaotic. Dealing with emotions is difficult.

I also realized how important the language we use is. In the operating room, I heard the anesthesiologist say, "We are losing the patient; she is slipping away."

As a physician, I understood the reasoning. But as a patient, I realized how devastating those words were to hear. We doctors often do not realize how much patients attend to every word we say.

I wrote an article about this: Never-Words: What Should Not Be Said to Patients with Serious Illness?

For this, we spoke with our colleagues and discussed the effect that different language can have on patients. For example, instead of saying, "There is nothing more we can do," we can say, "This treatment was not effective in controlling the cancer, but we still have options to improve your symptoms and quality of life."

Much of my current work focuses on communication training that is not only compassionate but also efficient. One of physicians' greatest fears is that opening the door to emotional conversations will take too long and prevent them from completing their work. But that is simply not true.

If we do not acknowledge emotions or take the patient's anxiety or fear seriously, the patient becomes less engaged in the process. People cannot listen to rational thoughts when they are experiencing intense emotions. But when you simply say, “I can imagine how frightening this might be,” the patient feels understood and can move through the process in a healthier way. I am trying to help physicians understand that this kind of communication is not actually a waste of time.

There is scientific evidence showing how effective empathetic communication is in patient care. This type of communication improves patients' adherence to treatment, reduces the need to return to the emergency department, and improves the management of chronic diseases.

I learned this awareness from one of the surgeons who operated on me. At the time, I was not aware of my own anxiety. I asked him many technical questions: "What material will you use for the repair? Mesh or an allograft? Since I work in the hospital, how will we minimize the risk of infection?"

He turned to me and said: “I want you to tell me what you are most afraid of.”

I paused and then admitted: “I am afraid I will come out of surgery with an ostomy bag.”

Looking into my eyes, he said, “I cannot tell you how much I do not want that to happen to you. I will do everything I can to prevent it.” .

After that simple question and answer, I understood that doctors' real task is to carry their patients' fears . I did not know that my fear could not be overcome with data. Until that moment, I had thought, “If I have the right data, I will feel better.” But nothing could have been more reassuring than the surgeon acknowledging my fear and carrying it alongside me.

Ignoring Emotions Does Not Make Sense

Health care is, by its nature, a deeply emotional field. It does not make sense to ignore this and manage the process through medical decisions alone.

One of the things that helped me heal during my time as a patient was the empathy shown by the people around me. During my first hospital admission, a radiology technician saw the hospital bracelet on my arm and asked: “Did you have a baby? A girl or a boy?”

At that moment, I had to say that I had lost my baby. The technician and I embraced and cried together. A patient transporter was standing beside us, trying to understand what was happening from what he saw. Seeing someone else face the reality of my life in that moment was an indescribable experience.

As we returned to my room, the patient transporter asked, “Will you be having any more tests?” I thought he was asking to avoid having to transport me. But later, when I went downstairs for a computed tomography (CT) scan, he was there again.

When we reached radiology, he handed the papers he was carrying to the technician and quietly said, “Do not ask her about the baby.” .

This person understood that protecting me was his responsibility. And he was not the only one: throughout the long months I spent in the hospital, the entire transport team followed this rule. If they were taking me to a department, they informed the people there beforehand so that no one would ask me about the baby. It was one of the truest acts of love I have ever felt in my life.

Everyone's Role Is Bigger

Whatever our role on the health care team, we have a responsibility not to remain indifferent to the suffering in front of us. We all have a purpose that reaches beyond the area in which we work.

When I started medical school 25 years ago, we were taught that we should not feel emotions, because doing so would make it difficult to care for our next patients. We were supposed to remain neutral and detached in the clinic; otherwise, our emotions might cloud our clinical judgment. They used the concept of “aequanimitas” for this: Clinical distance.

I do not believe in that. In fact, the people who taught us this had not developed their own emotional capacities, and the only way they knew was not to touch emotions at all.

But medicine is changing now. It is not as it once was. We can reshape health care through our own values and a new awareness.

Dr. Rana L. Awdish is a specialist in pulmonary and critical care medicine, director of the Pulmonary Hypertension Program at Henry Ford Hospital in Detroit, and medical director of Care Experience at Henry Ford Health. She is the author of the memoir “In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope.”