We Assume

Jacqueline lay calmly in a hospital bed as the kind young doctor gave his report. He sympathetically explained, “I’m sorry that the ovarian cancer has continued to grow despite all the treatments. The cancer is terminal at this point, and in fact, you may only have weeks to months to live. We recommend hospice, where you can be comfortable at home.” 

Later that day, when I went back to visit her, Jacqueline was agitated. She quickly pleaded, “Don’t push me out of the hospital.” She told me she’d accepted that she was dying, but she didn’t have a place to go. She was homeless.

Jacqueline felt better in the hospital than she had for a long time. Competent staff attended to her. She could eat whatever and as much as she desired. And she lay in a bed with clean sheets in a safe, climate-controlled room.

We had assumed that she would want to be discharged from the hospital. But for Jacqueline, the hospital was paradise. 

We assume people share our priorities, our circumstances,
or our view of what is best.

Mrs. Jones, in clinic, was instructed on how to take her once-weekly medication. The nurse practitioner asked her to set aside a morning for the process. “Say, Sunday morning, when you don’t have anything else going on.” Mrs. Jones turned to me with wide eyes, “I go to church on Sunday mornings. It’s the only thing I do all week.” 

The nurse practitioner assumed Sunday mornings would be free for Mrs. Jones because they were for her.

Darla’s father was ready to be discharged from the skilled nursing facility after rehab for a hip fracture. The report was that he would need long-term care. But Darla was insistent on caring for her father at home. Though it took quite a bit of work getting supplies, training herself, and hiring others, she successfully did so.  

The staff assumed her father could only be cared for in a facility. Darla was able to keep her father in her home. 

We make assumptions all day long. Usually, they are harmless shortcuts that help us navigate the world. But we don’t realize we are making them. We assume people share our priorities, our circumstances, or our view of what is best. The first option in our mind may not be the only option. 

These stories remind us that reality is often complicated. While we want simple solutions, sometimes those are not the best solutions for our patients. Get to know the people you work with and be open to other options. The multiplicity of paths makes the world beautiful.