Two Simple Words

• By Hope Lafreniere
• November 15, 2017

 Marcus Engel is an author and founder of the I’m Here Movement, which focuses on teaching health care professionals the importance of compassionate communication with patients and interprofessional teamwork to improve patient care. He is a certified speaking professional with the National Speakers Association and an author of four books that teach strategies for excellent patient care.

Engel received his Bachelor of Science in Sociology at Missouri State University and received his Master of Narrative Medicine from Columbia University in New York. He is a fellow of Columbia University’s Narrative Medicine program and adjunct faculty member at the University of Notre Dame.

Engel’s presentation “The Other End of the Stethoscope” about the importance of compassionate communication with patients and teamwork between all of the patient’s caregivers was the keynote address at the Office of Interprofessional Education’s annual Interprofessional Education Symposium.

Engel was left blinded after a car accident and has undergone more than 300 hours of reconstructive facial surgery. Engel chronicles his lengthy recovery from massive trauma and shares the compassionate communication shown by his care team.

“Human presence is the cornerstone of humanity,” Engel said. “If there was no suffering or pain, there would be no need for health care. Recognizing suffering and empathizing with someone sets us apart from other animals. Sitting with someone in non-judgemental awareness is the greatest gift we can give.”

Marcus Engel remembers a few things from the night he was a passenger in a car that was broadsided by a drunk driver. He and his friends had left the St. Louis Blues season opener against Ottawa when a car struck them at the intersection of Hampton and Chippewa in St. Louis.

“I remember the headlights,” Engel said. “Behind the headlights was a white car, and that car was going very fast. From the time I saw those headlights, I went into shock. Shock is a gift the human body recevies when we experience trauma so great, and our brain can’t process it. I do not remember how the car rolled three times, and I don’t remember how I got out of the car. I do remember waking up face down with my head on the pavement in agonizing pain.” 

The collision occurred three miles from a trauma center, making the accident response time quick. Engel could not breathe because of the injuries to his face, and a paramedic, who he later learned years later was named Mark, performed a crycothyrotomy, an incision into the throat to open the trachea allowing air to fill the lungs. Unlike a tracheotomy, a cricothyrotomy, or a crike, is performed in the field with extreme circumstances and accounts for one percent of all emergency department intubations. After Engel met Mark decades later, he learned that the crike Mark performed that night is the only crike he has performed in his career as a paramedic.

 “I am thankful I do not remember certain things from that night,” Engel said. “My world was filled with pain, fear and darkness, but I could feel someone holding my hand. I knew it was a woman.  As I was in and out of consciousness, she would squeeze my hand, and I would squeeze back. I can hear her saying, ‘My name is Jennifer. You were in a car accident. You’re in the hospital. She held my hand all night, and she would repeat the two most compassionate words: ‘I’m here.’” 

Engel only knew her as Jennifer. He did not know her role in the emergency department. He was not sure if she even existed. Twenty years later when Engel was invited to speak at the Barnes-Jewish Hospital, the hospital where he was treated for his injuries, he finally met Jenny again and learned that she was a patient-care technician studying to become a paramedic when she first held Engel’s hand. She now serves as the director of the Emergency Department at the Barnes-Jewish Hospital. Jenny would go on to adopt Garrett, Engel’s service dog after his retirement.

“Where does a 20-year-old patient-care tech stand in the hierarchy of medicine?” Engel asked. “Jenny didn’t have the years of experience or the alphabet soup after her name, but she gave me what I needed most, which was human presence.”  

Engel expressed that all health care professionals matter when it comes to a patient. Simple courtesies along with communication between professionals make the difference in the patient’s experience and recovery. Engel knew most of the names of his caregivers while he was in the hospital, which he attributes to the quality care and compassion he received.

“When I went into my first reconstructive surgery, a nurse named Barb came in to tell me everyone who was going to take care of me,” Engel said. “She was so complimentary of her colleagues. I could tell she liked her job and that she had confidence in the professionals around her. She told me everyone who was going to be caring for me, down from the shift change nurse to my physician and physical therapist. I knew ahead of time who was going to come in and what their role would be. I knew the care I was going to receive was going to be seamless. I remember she said, ‘I get to take care of you.’ She made it feel as though it was her honor to be my nurse just by using the word ‘get.’ Barb quickly became one of my favorite people. 

Engel asked the audience to consider treating patients with compassion and to empathize with what they are going through. By showing confidence in colleagues and the institution you are working for, Engel said, a patient’s anxiety is more at ease about the quality and type of treatment they will receive.

Barb would go on to become a good friend to Engel as he spent months in the hospital. He was released on Thanksgiving Day six months after the accident. Engel said he felt a lot of emotions, even sadness that he would not be able to say goodbye to those who cared for him.

“I was about to leave, but then I heard the elevator doors open,” Engel said. “I thought we were going to get on, but then I heard someone come off and I felt these arms around me. I knew it was Barb. She left her Thanksgiving dinner to say goodbye to me.” 

The simple act of kindness from Barb made an impact on Engel, who dedicated his book, “I’m Here: Compassionate Communication in Patient Care,” to Barb and her son, who lost his life to a rare form of testicular cancer.

“Always ask what you can do for your patient,” Engel said. “They may not remember your name, but they will remember how you made them feel.”

For more information about Engel and the I’m Here Movement, visit https://www.marcusengel.com.