When a doctor becomes a patient
Sonder Collins Dec 28, 2018
He’s lying on his bed crossing the last t and dotting the last i on his will. As he sits the paper down, he grabs his phone and shuffles through a playlist. He finds a favorite song, clicks play and closes his eyes.
“And anytime you feel the pain, hey Jude, refrain. Don’t carry the world upon your shoulders.”
As the music continues to hum, he feels a sense of calm wash over him. He knows he’s going to make it through to the other side. As the song ends, the doctor on his case comes in and says it’s time to go into surgery. He takes a deep breath and his wife leans in to say how much she loves him. As he is wheeled into the operating room, the anesthesiologist leans over and asks, “Are you ready, Dr. Shields?”
All in a day’s work
As a radiology resident at Indiana University School of Medicine, Jared Shields, MD, regularly reviews scans of patients who have experienced the worst day of their lives. From gunshot wounds to tumors, the diagnoses found in radiology is critical to medicine as its findings can forever change the lives of patients. Until earlier this year, Shields was always able to experience this from a doctor’s perspective, putting distance between himself and the emotions that are intertwined in a patient’s experience when visiting a hospital.
“It’s easy as a physician to lose sight, to know that your 8-to-5 job isn’t a normal experience for the patients walking into the hospital,” Shields said. “It can often be nerve-wrecking and confusing for them.
That all changed in late January of this year, when the Department of Radiology and Imaging Sciences had a unique research opportunity. Volunteers were needed to receive a whole body magnetic resonance imaging (MRI) scan, and Jared decided to take the offer and participate.
“I had had this bad head cold,” he said. “With all the patients who’ve come to me with head colds, I thought it would be interesting to really see what the brain looks like at this time.”
A slow-moving wrecking ball
However, Shields was in the scan longer than anticipated, and was greeted by neuroradiology expert Chang Ho, MD, when he emerged.
“Dr. Ho asked how I was doing and told me to sit down. He then pointed to a screen and said, ‘This is your brain,’” Shields said. “As I leaned, in I noticed a benign, golf ball-sized tumor on my brainstem.”
His tumor was so large that it wouldn’t take a medical degree to realize that someone was abnormal. For a practicing neuroradiologist, it took less than a second to recognize the tumor was called vestibular schwannoma, a noncancerous slow-growing tumor that develops within the nerves that support facial animation, balance and hearing on the left side of the head.
“Imagine your vestibular nerve is a copper wire with a blue, rubber coating on the outside, that is the schwann cells. My tumor is just an abnormal collection of those cells that has grown out of control,” Shields said. “And mine had probably been growing for a decade, like a slow-moving wrecking ball.”
As the news sunk in, Shields began to think of his wife, who had just found out a week earlier that she was pregnant with their second child. A flood of emotion swelled over him, causing him to feel like an island, isolated and alone. For the next two months leading to his surgery, Shields debated over how to tell people, how to ensure his family would be taken care of no matter what happened, and what friends and other residents would think.
“It’s easy to get into a downward spiral and just seclude yourself when you’re given this kind of news,” he said.
Sharing his story
However, as the date of his surgery neared, he began to tell more people about his experience, including current medical students. Shields connected with Richard Gunderman, MD, PhD, vice chair of education for the Department of Radiology and Imaging Sciences, to discuss creative ways he could share his story. Together, they did a session with fourth-year medical students where Gunderman gave a review on neuroanatomy, and Shields talked about his experience as both a resident and, now, a patient.
“The more you tell people your story, the more you share your vulnerability and imperfections, you eventually find out that you’re really not that alone after all,” Shields said.
Listen to Shield’s journey from doctor to patient in the new podcast series, MedStories.
This support continued to grow the weeks leading up to the surgery. From colleagues and friends to church members and strangers, a whole community had sprung into action by the time Shields was in the operating room, letting him and his family know they were anything but alone.
The 16-hour operation, was led by Rick Nelson, MD, PhD and Mitesh Shah, MD. The intricate work by Nelson and “Meticulous Mitesh,” as Shah is often called, was a well-synchronized dance that involved delicately removing the tumor without damaging any nerves. Though Shields did lose hearing in his left ear, he knew that this was likely to occur considering the surgeons had to enter his brain directly behind his left ear.
“Going into a major operation like this, you start to appreciate small things that you didn’t even know you could take for granted—like the ability to smile,” said Shields.
A total success
Eight months after his operation, Shields’ facial nerves continue to improve—he’s even set his sights on trying to whistle again. As he gets ready to celebrate a first Christmas with his three-month-old son, he’s also chiseling at the list of thank-you’s for all the people who supported him. The people who made him feel less like an island, and more like a continent.
“I was top dog in high school and did really great in college, but you’re going to get to a pond eventually where you’re not the biggest fish anymore. And sometimes it hits people early, sometimes it hits people late, but when you finally realize it you can feel inadequate and then feel alone or isolated,” Shields said. “It’s easy to tailspin and spiral into negativity. It’s at these times when it’s crucial to realize that you aren’t as isolated as you believe and to know where your channels of support are. I mean, it took a brain tumor for me to wake up. I guess I’m hopeful that others will realize this earlier.”