Grabbing The Teaching Moment

“It was an incredible and startling experience,” the resident said after we talked about the patient and husband we had recently seen in my geriatric ambulatory clinic at Baycrest Geriatric Health Care System. It was quite different from what I would have expected prior to such an experience from someone who had survived the Holocaust and went through so much”.  He continued, “I realize I must take the time to explore what actually happened to people who came from Europe before or after the Second World War in order to appreciate their medical and personal histories. I think this will make me a more sensitive physician and I feel a bit more confident and comfortable exploring such potentially emotionally charged remembrances after today’s experience”.           

This discussion occurred after I asked the medical resident to join me in the room with my patient and her husband. We had just finished reviewing the patient he had seen and I wanted him to have an opportunity that I thought would be unique. He was a mature first year post-graduate resident in family and community medicine who grew up in the Maritimes and, prior to medical school had a computer science career in the high tech industry. With that history, I imagined that he was about to experience something unique.

            I had been following the female patients for a number of years because of progressive Alzheimer’s disease. I asked her husband if I could discuss their experiences as Holocaust survivors. They were in Toronto for a short period- a break in their usual winter stay in Florida in order to attend the wedding of a grandson. He explained that her cognitive condition had been gradually deteriorating which was expected. However, during the short period in Toronto she was experiencing a bit more agitation – which he attributed to being “cooped up” because of the weather in Toronto whereas in Florida they had a nice routine, which allowed for walks and sitting by the pool, which she found relaxing.

            I then asked him to tell the resident and myself when and from where they came to Canada. “We were originally from Radom, a mid-sized city close to the middle of Poland, but did not know each other there. Before the war, Radom had a vibrant Jewish community of more than 30,000, most of who perished during the Holocaust. I survived Sachsenhausen, a concentration camp in the Berlin district and my wife was a survivor of Auschwitz”.

            I turned to the resident and asked him, “Have you ever met any Holocaust survivors?” He said that prior to coming to Baycrest he had not, and even during the current rotation had not had any in - depth discussion with an individual who had experienced the Holocaust. I shifted my gaze back to the husband and asked, “Do you mind telling this young doctor something about your history with the Holocaust and how you managed to survive - that is if it is not too much for you?” I could see his face take on a look of determination and it became quite clear that he appreciated the opportunity to tell their story which he did without any further prompting from me for the next 10 minutes.

            “I was interred for three years in Sachsenhausen, which achieved its murderous goals by starvation and illness and, when directed by the Nazis, by execution through shooting, hanging and eventually by gassing or by transferring prisoners to the other death camps like Auschwitz where my wife was a prisoner. At the end of the war thousands of prisoners died during the death marches that started in April 1945 to avoid capture by the Allies”. The story mesmerized the resident. The husband continued, “This is my wife’s number” as he rolled up her sleeve to reveal the pale blue number, many of which I had seen over the years of working with the large Holocaust survivor population cared for by Baycrest. “Here is mine,” as he rolled up his sleeve”. “It is a number I will never forget”.

            He then went on to describe with body language and got out of his chair to demonstrate vividly and through his actions, how he survived a critical event of his incarceration. On one day when a “selection” by notorious SS doctor Friedrich Mennecke was taking place to decide who would stay and work and who the Nazis would execute or send to the death camps -- he devised a way to outsmart the “doctor” and avoid certain execution.  He leapt from his chair and showed with a full flourish of movements, which appeared to be imbedded in his psyche, how when the “doctor” turned his head, he quickly ran from the line of inmates waiting to be “selected” to the line of those clearly destined to remain in the camp. It worked, and he survived, hunger, illness and brutal working conditions until liberation.

            After some years in Israel where he met and married his wife, they moved to Canada. He worked, raised a family and was now about to enjoy the wedding of his grandson, evidence of his and his wife’s survival while at the same time contending with the devastating illness affecting his wife, who he always referred to with deep affection in his voice and eyes,  as the “love of my life”.  

            For the resident I hope and believe it was one of those rare moments in medicine where one’s world changes. A live witness to the Holocaust and all its brutality had counterbalanced what was for this young doctor a theoretical understanding of its history the current media coverage to attempt to deny the Holocaust’s reality or significance. As a teachers of medical students and those in post-graduate programs, we must always strive to grab the moment, whatever it may be, the clinically unusual, the therapeutically profound and the emotionally riveting – to bring our trainees to internalize the best that medicine has to offer as a career – endless challenge, and limitless opportunities to express their humanity as physicians.