The patient who changed my life
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    A six weeks column illustration for De Volkskrant
    Published:
DE PATIËNT DIE MIJN LEVEN VERANDERDE
/the patient who changed my life


CLIENT | De Volkskrant
FIELD | Editorial illustration



I illustrated a six weeks column for De Volkskrant titled De patiënt die mijn leven veranderde / The patient who changed my life. All of the stories dealt with heavy subjects and I had very little space, both materially and figuratively, to create a metaphor linked to the story; I hope not to come across as insensitive or offensive to anybody with these illustrations.

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The first story was about the parents of a 6 years old girl that was found to have terminal cerebral cancer. In the article the doctor recounts the parents' decision to go straight back home with their daughter and live the last months together “normally”, far from hospitals.

The doctor express his doubts and frustration at not being able to help, but also reflects on the possibility that, sometimes, treatment might not be the best option -both for patients and their families. Sometimes is better for doctors to hold back and do nothing. Hence the illustration. The doctor is not there.
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The second story was about a professor in psychiatry who started studying a patient for research. The two of them soon developed a close friendship, after all they had much in common: same age, similar interests, same taste in music; Steven though, the patient, had been hearing voices his whole life.

If people tell a story, the professor explains, the left half of their brain is active and the right half is silent. In people who hear voices, suddenly, the right side starts chattering as well. Antipsychotics are not as effective for everybody-and for Steven they weren’t; but she managed through TMS therapy (look it up) to improve significantly his life.

Interestingly, also music played for him a big role in coping with the voices, and a new therapy proposal related to singing is currently being developed by her and her team in Utrecht. Probably due to the way hearing voices works in the brain, when Steven plays music (he is an historian and a drummer) the voices finally quiet down.

Double take. Those are not closed eyes.
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In the Netherlands, it is a tradition at the birth of a baby to offer to visitors beschuit met muisjes: anis seeds coated in sugar, sprinkled over a rusk with a layer of butter. The one here is cracked, so you know where this is going.

The doctor describes being called up to assist a couple in the middle of the night, the woman had just given birth to a premature baby girl of 25 weeks. For premature babies younger than 26 weeks it’s the parents’ choice whether to treat them or not; usually girls have a better chance at survival once put in intensive care. The couple was considering moving abroad for work; they weren’t sure how to combine their career plans with the care that the baby would have needed and possibly the baby could have developed a disability; in the end they decided not to treat the baby.

A year later, the doctor was called up again: the couple was again pregnant, the woman had just given birth to a 24 weeks boy. They ended up not moving abroad, and that night they expressed serious doubts about the decision they took a year before; they wanted to treat the baby this time, but it didn’t work. The doctor goes on to doubt the belief that patients or their family can always choose what’s really best for them at all times. This couple had to make an important choice in the middle of the night, the woman was exhausted and wounded, they had no family or friends to consult and little time available; he implies they took the wrong decision not treating the first baby. (Although he makes an interesting point about taking decisions under pressure, the conclusion sounds moralist to me).
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Fourth story. Elise was defined from her foster parents as “the perfect daughter”. Immediate big red light for the therapist. Good grades at school, described as social, loving, and intelligent, she was actually completely closed off to the rest of the world. The girl had lost both her parents at the age of 8 in an accident and in the foster family there wasn’t much talk about emotions. She adapted to the trauma acting like she thought others expected from her, with no idea on how to deal with her inner emotions. Hitting puberty, resisting food became a response to the frightening changes ahead; and so there she was, 38 kg. It’s shocking to witness what anorexia does to a body, but it is a complex reaction for girls and boys, men and women, to feel like they are still in control when life gets overwhelming.

Luckily Elise improved through MBT therapy; for young people it’s much easier to get back from what often becomes a chronic condition for adults. The therapist in the article calls her a “Barbie” so the metaphor was pretty much served there. Barbies can’t eat their plastic muffins even if they tried, restrained by an impossibly eternal toothpasted smile.

How grotesque to think that “doll” is still a word used as a compliment for people.
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‘“Ben,” she told me one day, she used to call me by my first name, recounts the doctor. “Ben, don’t you ever have something else to say? I know I'm going to die, but can’t you just tell me for once something different, something nice?” She made me realize that the patient in that bed was not just a disease but first and foremost a human being -and that I had to do more for her than just transferring technical information.’ 

In this week’ story a doctor recounts the time when, as a young aspiring specialist working at the hospital, he met a woman with ovarian cancer who made him aware that relationships with patients were nothing less than human relationships. The doctor’s own mother died young; and yet he could still remember that her GP went home to see her daily. He could not do much for her, but he would take off his coat, and seat next to her bed. That memory always lasted with the doctor, together with the significance of making time for patients.

Eventually he decided to leave the hospital, where he found his work too detached and impersonal, and went on to become a general practitioner himself; finally as a GP he felt he had the chance to build more meaningful relationships with his patients, and through real listening to give them the support and care they needed.

A while after he opened his practice, a woman came by with a bottle of wine and a letter that the woman from the hospital had wrote for him before dying. “This way you can see what a doctor and patient can do for each other” writes the doctor, ”I'm there for them but they are definitely there for me too." 

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Last story of the serie! A kick to the gums just like the ones before, but also very important to consider in my opinion.

A man, a young father with growing adolescents, suddenly collapsed at work. A few hours after being taken to the hospital, he was soon overwhelmed by a major brain bleeding; the doctors found that all his brain functions had failed. They briefly left intensive care to give their condolences to the wife, sister and silent kids and, carefully, asked about organ transplant after finding no disclosure of the man’s wish in the donors' register. His wife gave immediately permission to proceed, and sat in the hospital for the next five hours straight procedure. 

Six weeks later, the doctor in charge that day called the woman to ask whether she wanted to know what occurred, as she would usually do with the family of a donor. She went all the way to their house; while sitting in an unfamiliar living room, seeing for the first time a photo of the man she had only saw lying on the operating table, she told the wife what happened.

Thanks to them both, his kidneys, his heart, liver and pancreas went on to five patients who could now lead a normal life again. Five human beings.