Boston Med: The Patient-Doctor Connection

July 22, 2010 — -- Doctors and health care providers may be used to treating life-threatening illnesses, but that doesn't mean they grow immune to the emotions that emerge in caring for patients.

When Dr. Kimberly Parks, a transplant cardiologist at Massachusetts General Hospital, was first introduced to her patient, Marvin Pollet, she felt an instant connection. "He was the kind of person that you immediately liked. He was very polite, very enthusiastic and he was grateful. He was so excited to come here," Parks said.

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In November 2008, Pollet, a 55-year-old private investigator from Louisiana, was diagnosed with amyloidosis, a disorder in which the body produces an excess amount of abnormal proteins that attack multiple vital organs. When amyloidosis involves the heart, it can result in cardiac failure.

"His cardiologist told me they did not expect him to make it through the night," recalled his wife, Jeannette. "He went to work that day, began a new medicine and passed out. His blood pressure plummeted, and his kidneys and liver started shutting down. That was the night of our 25th anniversary."

With his health worsening by the day, Pollet, along with his wife, flew to Boston where he was admitted to Mass General under the care of Parks and a team of specialists. "I didn't want anyone to stamp me with a time and a date saying 'this is as long as you could live,'" Pollet said. "It's almost like a threat to me."

His only real chance at life was a heart transplant. "Marvin came to Mass General looking for hope and we gave him that," Parks said. "Regardless of what the outcome was going to be, he was grateful. He had so much love for his family, he had so much love for life."

Race Against the Clock

Over the next several days, Parks and her colleagues worked tirelessly to get Pollet listed for a heart, and her bond with the Pollet family deepened. "[That is] the art of medicine, the gift of guiding people through the most painful experiences of their life," she said.

"I had a very special connection with Marvin. We had to work very hard very quickly to get him listed for transplant, and everyone made heroic efforts. We all sat each day hoping, waiting, praying," she said.

For many health care providers like Parks, getting attached to patients and their families is often an inevitable but rewarding part of the job. "I think the best doctors do connect on an emotional level with their patients," said Dr. Paula Rauch, a child psychiatrist at Mass General.

"There are limits to what we can fix, but what we can do is be emotionally present. If you know you can't fix everything, and you know you didn't cause it, and what you can do is be present with someone, then that is an incredibly privileged position to be in."

Thanks to Parks' vigorous lobbying, Pollet got the news that he was finally listed for a heart. His fight for survival became a race against the clock, an agonizing wait for a donor to become available in time.

Amyloidosis causes the body to rapidly decompensate, and vital organs such as the liver and kidneys quickly begin to shut down.

Knowing the gravity of Pollet's situation, Parks decided to share a special gift with him. "When there's something very extenuating, then I like to give a symbolic gift," she said. She gave Pollet a heart made of marble.

"I wanted him to sort of keep that as a reminder of all the people that got together to help him get listed for a heart transplant, and just to help him stay strong mentally during his wait because I knew it was going to be a tough time for him. "

While waiting for a donor heart, Pollet's condition continued to deteriorate. He developed life-threatening complications related to his illness. "I knew things weren't going to turn in the other direction." Parks said.

'We're All Human'

Pollet lost his battle with the disease March 2, 2009. Parks said it was a very difficult loss for her. "When you get to know the person, and you've followed them for months, and you know their families, then you see them at the end of their life, it's a much different experience," she said. "You feel like, Gee, I'm supposed to be this strong physician, I'm supposed to be in charge. But we're all human."

Health care providers know they will have to face unfortunate outcomes, and Parks and her colleagues have been trained to cope with these difficult situations by relying on one another.

Rauch, the child psychiatrist at Mass General, stressed the importance of doctors seeking the support they need. "Over a long career, people learn better and better ways to be connected and also to take care of themselves emotionally so they can stay connected without developing what people sometimes refer to as compassion fatigue."

Two months after Marvin Pollet's death, his wife and her children held a fundraiser in his honor in their home state of Louisiana. Parks believed it's important to attend and show her support for Jeannette and her family.

"It was a very nice way to make something happy out of something sad, to have closure and have it be a positive ending," said Parks. "I see my job as continuing even after a patient is gone. Somehow you feel your presence is still helping Marvin."