A Quick Note on Dr. Hilgers

My wife has been advised to be as active as possible, sitting up rather than lying down, walking rather than sitting, so we are currently outside on the rather nice patio of Creighton University Medical Center (unfortunately overlooking the highway), where we are engaging in one of our favorite, but recently neglected, joint pastimes – Scrabble. So I don’t have time for a full update, but I wanted to mention something we appreciate about Dr. Hilgers, now more than ever: his kindness and patience. He has enlisted the advice of a gastro-intestinal surgeon and a general practitioner, both to give him advice on my wife’s probable ileus and to prescribe various fluids for her IV. A young and rather jaunty doctor, who seems to be working under the GP, blew into our room yesterday when we were feeling pretty optimistic and announced to my wife, “Well, you look great, but your x-ray doesn’t!” He made a jokey comment about how he was happy to see her distended small intestine, because surgeons love when things are difficult, rather than easy. After reassuring us by saying that he treats the patient, not the x-ray – in other words, that in the absence of corroborating symptoms such as nausea and vomiting there is not enough reason to assume a blockage of the bowel and therefore no reason to operate – he blew out of the room again, residents and fellow doctors following in his wake, leaving us mouth agape and my wife jittery and nerve-wracked.

Dr. Hilgers, who has been in every morning, came in today when I was not here, having left very early to pick up my dad at his hotel for Mass and then a trip to the airport. Dr. Hilgers and my wife had a good conversation. She mentioned this doctor and his extremely poor bedside manner and how it had jarred her, how she’s now imagining all her worst fears. He asked her to tell him what she was afraid of. Other than death, she’s afraid of a permanent nutritional IV – never being able to eat again. I think doctors have to strike a balance between needlessly informing patients of worst-case scenarios, thus stimulating their fears, and limiting their fears by setting the boundaries with a worst-case scenario. In this case, Hilgers rightly chose the latter, telling my wife the worst-case scenario would be a temporary colostomy – six months is the figure he put on it – because the small intestine always wakes up. It just does. He also let her know what the next step will be: tomorrow, if the passage of gas continues and the vomiting doesn’t come back, we’ll try the wet tray again. If she keeps it down, we’ll go to the dry tray. His attention to us, his apparent knowledge, his willingness to explain and answer questions, are all qualities we value highly in him. They’ve made an unexpectedly-difficult recovery that much more endurable for us.

Update: My wife and I have been reading this over before I post it (we’re no longer on the patio playing Scrabble – I’m winning by the way – as these postings always take longer than I think they will to write), and we’ve just realized that we’re not quite sure, now that we think about it, how a colostomy would allow her to go on while waiting for the small intestine to wake up. A colostomy replaces the large intestine, if we understand this correctly, because the large is concerned almost exclusively with disposal, which a colostomy bag can do, while the small is concerned with distribution of nutrients to the body, which a colostomy bag can’t do. Clearly we’ve missed out on some details somewhere along the line, but Dr. Hilgers will no doubt answer them for us when we see him tomorrow.