In Shock

A doctor’s near-death experience inspires a book

By Ashourina Slewo

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In 2008, when Rana Awdish, MD was seven months pregnant, planning for the arrival of her baby and finishing up her fellowship at Henry Ford Hospital in Detroit, a tumor in her liver burst open. Awdish had been unaware of the tumor and as a result of the burst, lost massive amounts of blood volume into her abdomen. Awdish required a blood transfusion to replace her blood volume and was placed on life support as she suffered multi-system organ failure and had a stroke from the loss of blood.

 “The baby died from lack of blood flow — a complete placental abruption — and ultimately I spent the next six months recovering from that first event,” Awdish recalled. “This happened at the end of my fellowship training to be a pulmonary and critical care specialist, and while I thought I knew something about what it meant to be sick, what it meant to be a patient, I learned that I had so much more to learn.”

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Suffering the loss of her child and nearly dying herself, Awdish’s recovery would be no easy feat. Ultimately, her recovery would take many years and five major surgeries including having to have a portion of her liver removed. “I had to relearn to walk, speak, and do many other things I had taken for granted,” she said. 

It was during her time at the hospital that Awdish learned truly what it meant to be a patient. Surrounded by her peers and colleagues, she, learned things about providers that have changed not only how she conducts herself as a doctor, but her organization as well. 

“It was very eye-opening,” she said. “In the process, as a patient, I learned things about providers that I might not have wanted to know. I learned that though we do so many difficult, technical things so perfectly right, we fail our patients in many ways. There were disturbing deficits in communication, uncoordinated care, and occasionally an apparently complete absence of empathy. I recognized myself in every failure.”

Statements made to Awdish like “trying to die on us” forced Awdish to take a step back as she realized she had said that exact statement many times to her own patients. How many times had she angered or hurt patients with flippant statements like this?

“As critical care fellows, we had all said it,” Awdish said. “Inherent in that accusation was our common attribution of intention to patients, we subconsciously constructed a narrative in which the doctor–patient relationship was antagonistic. It was one of many revelatory moments for me.”

Rana’s transition from doctor to patient revealed many of the shortcomings of providers. From being doubtful of her level of pain to receiving a bill for the attempted resuscitation of her baby, there was a clear lack of empathy and Awdish wanted to change that.

“A trivial oversight, by a department ostensibly not involved in patient care, had the potential to bring me to my knees,” she said of the bill. “My experience changed me. It changed my vision of what I wanted our organization to be, to embody. I wanted the value of empathetic, coordinated care to spread through our system. I shared my story openly. I wanted the system leaders and every employee to know that everything matters, always. Every person, every time.”

Following her recovery, the doctor turned patient took to writing her book, In Shock. In her book, Awdish recounts her journey and calls on doctors to embrace the emotional bond between doctor and patient. “This is a book about the power of love, of hope, of being present for suffering of others and how transformative that can be,” she explained. “I wrote this in a way that will truly allow readers to experience my journey alongside me. They will see what I saw and feel what I felt.”

Through her book, Awdish hopes that readers, doctors and patients alike, learn the importance of communication. “We are each part of the solution to suffering,” she said. “In so many ways, we have the power to heal each other.”

Released on October 24, In Shock can be found at Barnes & Noble, Books a Million, IndieBound or on Amazon. For more information about In Shock  and Rana’s journey, visit https://www.ranaawdishmd.com/