Tuck someone in today

One of my colleagues, Nancy, recently shared a surprising experience that she had with her son—one of four children—as she was getting ready to send him off to college. The night before he left, this strapping, six-foot-tall man, who plays football and lacrosse, made an unusual request: He asked his mom to tuck him in to bed. When he returned home for a long weekend, he again wanted to be tucked in.

Nancy and I talked about what it felt like to be tucked in: You felt safe and protected, warm and loved. It is a great feeling and we all need it.

“Tucking others in” is a beautiful image of the care that is often lacking in health care. I remember a discussion with a family about limiting care of one of their loved ones. The patient, Paul, was 50 years old with metastatic cancer. He was now septic, on a ventilator and unable to communicate. We were meeting with his wife, brother and sister in-law. It was difficult for them to accept that he was dying.

We sat down in a messy conference room crowded with notebooks, the walls covered in reminders to staff. I opened the conversation by asking if they could tell me what Paul was like. I hadn't had the chance to get to know him. All of their eyes lit up, and they told me how he loved to drive around the country to see Bruce Springsteen concerts. He was a ‘60s hippie who never changed. They described his hearty laugh and how he loved to play jokes on people.

I thanked them, and they thanked me for trying to understand Paul as a person. I then asked what they understood about Paul’s prognosis. We talked about what Paul would want done in this situation. The wife and brother looked at each other. Their answer: Paul would want to withdraw life support with Bruce Springsteen playing loudly and the rest of us tailgating in his hospital room.

And that is what we did. The next day, we gathered in Paul’s room, with “Born in the USA” playing. His wife lied in bed next to him, as she had done for thirty years. His brother brought in sandwiches, chips, sodas and pickles that filled the room with a life-embracing garlic smell. The nurse tucked both Paul and his wife into bed, and he passed.

Several hours later, the family came to me and said how comforting it was to be able to talk about what Paul was like, to be able to have him pass on their terms, with music and food, and to be tucked in. The wife said that is what she will remember about being in the hospital.

It is not just patients and families who need to be tucked in. We all do. We need to feel appreciated and at times comforted. Many of us carry heavy burdens. Once, a physician with whom I work yelled at several nurses. When I asked him why he was acting that way and reminded him that his behavior was neither appropriate nor reflective of the kind of person he was, he broke down, saying his wife was leaving him and that he wasn't dealing with it well. We got coffee. He said I was the first person he told and thanked me for listening. I saw a senior nurse chastise and shame a junior nurse. I asked the senior nurse if things were OK, saying she seemed harsh. She told me how she had just put her mother in a nursing home, her husband had lost his job, and she had gained 20 pounds from the stress. I put my hand on hers, told her how much I appreciate working with her and what a great nurse she was, and suggested she talk to someone. She then apologized to the junior nurse.

“Tucking in” patients and others is not just a nicety. It helps us heal, it puts joy in our work and it improves productivity. The little time that it takes to appreciate others is paid back 10 times over in improved productivity.

Imagine the love we would bring to the world and the suffering we would reduce if we made a habit to tuck someone in every day, just as Nancy did to her son going to college.