“We’ve got a new admission; I added her to the list,” my senior resident announced to the team. “Jackie Alberts, here with heart failure exacerbation.”
“Wait, I know her,” I replied, disbelievingly. “I sent her home with hospice three years ago because the side effects of her cancer treatment had become too much.”
One look at her photo in the electronic medical record confirmed it was the same patient. A review of her chart showed that since the last time I cared for her, her cancer had remained surprisingly stable without further cancer-directed treatments. However, for the past year, Jackie had been plagued by a series of cardiac issues. She had suffered a heart attack, leading to an ICU stay and ischemic cardiomyopathy, along with atrial fibrillation resistant to both rate control and ablation. The current admission marked her third heart failure exacerbation in as many months.
As the team and I went to admit her, I reintroduced myself. “Hi, Jackie,” I said, “I’m Dr. Caputo. I’m not sure if you recall, but I cared for you a few years back.”
“I remember you,” she replied in her stoic, familiar tone. “You’re my doctor.”
When I chose hospital medicine, one of the downsides I understood that I was accepting was sacrificing continuity for acuity. I’ve found myself passing this sentiment on to trainees choosing this specialty. However, as my relationship with Jackie showed, this isn’t always the case.
Throughout that admission, Jackie consistently refused her diuretics until I made rounds with the team each day. She would repeatedly say, “If you tell me to do it, I’ll do it, but I need to hear it from you because you’re my doctor.” I was touched by the depth of her trust. Even though I had only cared for her for two weeks three years ago, amid multiple readmissions and complications, she saw me as a familiar face who was focused on her goals.
Jackie was not an isolated case. During one post-call rounds, another familiar name appeared on the list, but this one evoked less positive recollections. This patient, Robert, had been admitted numerous times over the years, primarily due to issues stemming from opiate use disorder.
When I approached with my team, Robert greeted us. “Good to see you, Doc,” he said with a smile.
“Long time no see. How have you been?” I replied, immediately noticing the change in his demeanor. He used to be angry and defensive, but now he was friendly and welcoming.
“Great! I’ve been clean for four years now. This is my first hospital visit in over three years. Remember how I used to be in here every month?”
During Robert’s hospital stay, I learned how suboxone had helped Robert achieve remission from his opiate use disorder. He was a guitarist and had found his way back to music. He was working again. His health was the best it had been in decades.
Having known Robert when opiate use disorder dominated his life, I was privileged to see and celebrate how well he was doing.
“Our next patient is Leanne Walter, a 67-year-old female with oxygen-dependent COPD,” the medical student presented. I was proud of myself for letting the student finish their presentation uninterrupted. I’d treated Mrs. Walter countless times, though it had been over a year since her last visit. Frankly, I had assumed she had passed away. She’d had end-stage COPD as long as I’d been an attending physician. My colleagues and I had referred her to hospice on several occasions, but she had always graduated from their care.
“Oh, I remember you! I know everyone in this place. Did you miss me?” Mrs. Walter exclaimed as I entered the room. “I’ve been living with my daughter in North Carolina.”
She was the same as ever, hair freshly styled, a nasal cannula in her nares, and wheezing that was audible from the foot of the bed.
“I’m ready to go home,” she stated firmly.
My team looked at me aghast when I agreed to discharge her. They saw an active COPD exacerbation and feared impending respiratory failure. I saw Mrs. Walter in her baseline state of health. No amount of steroids or bronchodilators had ever resolved her wheezing, and she wasn’t one to push to go home until she felt back to her normal.
My experiences with Jackie, Robert, and Mrs. Walter prove that the perceived trade-off of continuity for acuity in hospital medicine is not always true. While the specialty is defined by short-term, intensive care, it still offers profound moments of recognition, trust, and shared history. These recurring relationships, unexpected as they may be, highlight a unique kind of continuity occurring at critical junctures of a patient’s life. It is in these moments that we, as hospitalists, are privileged to witness the ongoing narratives of resilience, recovery, and humanity, making the practice of hospital medicine surprisingly rich with lasting connections.
2026 National Hospitalist Day HM Voices Contest Submission
Dr. Caputo-Seidler
Dr. Caputo-Seidler is a hospitalist and assistant professor at the University of South Florida in Tampa, Fla