By Dr. Ashley Sens, CMO Woodland Healthcare

“Teaching is more than imparting knowledge; it is inspiring change. Learning is more than absorbing facts; it is acquiring understanding.”

– William Arthur Ward, Author

In my role as Chief Medical Officer for Woodland Memorial Hospital, I am sometimes asked to meet with patients whom physicians and nurses are concerned may decide to leave the hospital prior to the treating team feeling they are safe to discharge. When I get involved, it is typically because the team is concerned a patient-directed discharge could lead to the patient’s death. The stakes are very high for everyone.

I want to share with you an encounter I had with such a patient who taught me one of the most important lessons of my career.

Typically, the treating team and I would emphasize with these patients the dangers to them if they leave the hospital: “You are making an unsafe choice.” “You could die.”

However, this particular patient (we will call her Rose) helped me hear what those words sound like and feel like from the perspective of someone who has lived a life of severe trauma. The “aha” moment I experienced with Rose came when I realized Rose did not feel she was worthy of the care we were providing to her. All the threats to her safety and wellbeing were actually feeding into her impulse to leave – to run away, because, after all, what we were threatening is what she felt she deserved.

This insight did not happen because Rose told me explicitly she was not worthy of our care. The “aha” happened when I listened to her talk about her life and watched her squirm in the hospital bed. That was when I realized just how uncomfortable she must feel. For those who have lived a life of repeated and ongoing trauma, the trauma itself can feel more comfortable than safety, care, concern, or love – because it is familiar, and because their life experiences tell them they are not worthy of love.

So I stopped telling her she could die. I told her how much we care about her. I told her she was worthy of our care, that she deserved to be safe, and that she deserved to be well.

“We care about you.”

“You are worthy of our care.”

“Please stay with us and allow us to care for you. You deserve this.”

“You are worthy. You deserve to be well.”

Rose stayed.

— Dr. Ashley Sens, CMO, Woodland Memorial Hospital