Being a physician is so much more personal than I expected.
I think back to my early Harrell Center days when I blushed at the idea of taking
a sexual history and mumbled through awkward interviews with fake patients
probably bright as a tomato. Fast forward two years and the patients are no
longer paid or have a script. And I’m slightly less nervous and less red. I guess I never realized how privy
physicians are to the personal details of people’s lives and the connections we
make with our patients. What other career can you introduce yourself to someone
and in less than 10 minutes ask about how their mother died or how many beers
they drink a day or what makes them depressed? We ask patients questions that
sometimes their own family members don’t even know the answers to and it
baffles me that they almost always answer us.
This
year two worlds have collided: paper
and people. Pages from textbooks about diseases have come to life in the form
of people’s stories. Mneumonic devices may have helped me survive the first two
years but now its my actual patients that I cared for that help me get a
question right on a test.
Sometimes it’s weird to see the classic things you read about in
textbooks actually come to life. Fevers, night sweats, chills, and weight loss
are no longer review of systems to check off for malignancy. It’s about my
patient’s inkling something may not be right. The first two years prepared me
in the sense that I learned medical vocabulary but during third year, patients
are teaching me the language.
This year has gotten me to think a
lot about the human connection. Connections between classmates, between
patients and between family. I feel closer to my classmates because instead of
a group of 135 students in a large lecture room, it’s me and Corey making
dinner down in Vero Beach for our psych rotation, or me and Meera giggling in
our bunk beds in Jacksonville or me and Lauren mixing Crystal Light drinks at
the VA. By the end of second year, everyone is in a little group of friends or
clique in medical school but third year opens people up to become close to
classmates that were once just acquaintances. I’ll never forget me and
Laura in the OR with out
mouths covered with masks giving each other big wide eyes during a thrilling case.
Third year has been extraordinary and reaffirmed by decision to go to med
school.
Sometimes
connections between patients can remind you of connections with family. One of my
patients was an admit that originally was going to be my 5th COPD
admission for the month while I was at the veteran's hospital. Part of me rolled my eyes when
my resident told me to go interview the patient in the ED. Here we go again, I
thought to myself. I went through
a check list in my head“IV solumedrol, duonebs, supplemental O2 and check their
chest x-ray”. Instead, I would meet one of my most special patients of third
year. I entered the room where Mr.B lay exhausted on a hard bed, with his
smiling wife loyally by his side. Indeed, he had a COPD exacerbation but also
was told her had larygneal cancer only four days prior. With his first few
words, my ears perked up as my mind wandered to memories of my childhood.
Growing
up, I only knew my grandfather’s voice to be raspy and soft. He had laryngeal
cancer in his 40s and had a partial laryngectomy leaving his once robust, deep
voice, quiet and hoarse. When I met Mr.B, I immediately felt connected to him
because his voice sounded just like grandpa’s. My grandfather was quite the
character and known in our family for his quick wit and famous one liners. When
my mom got engaged at the ripe old age of 28, he told her that she was in the “4th
quarter with a two minute warning.” Mr.B was also a character and also quick
with the one liners. “I feel like a mushroom, they feed me and keep me in the dark”,
he told me when referring to the ENT doctors. Just like grandpa, Mr.B had
learned to use his hands and eyes to express himself despite his weak voice. It
was like watching a silent movie, eye rolls, dropped jaws, hands waving and
incredibly entertaining.
I
used to go to my Grandpa’s house in Coral Gables and bake him pies and visit
with him while the pie was in the oven. He would tell me stories about growing
up in Michigan, his car dealership and funny Zeder family memories. He was the
only grandparent that I still had by my adolescence and the one my memory best
honors. When he passed away my senior year of high school, I missed him
terribly but also mourned not having a grandparent figure anymore. Part of me
feels that I have an affinity for the elderly because I didn’t have enough
grandparent time as a child.
Meeting Mr.B brought the memories
of my grandfather right back to the surface. Each day, I found myself ducking into his room three or four
times, often staying awhile to hear stories of his chicken farm, or white
German shepherd, or his antique car collection. Sometimes I would forget to
actually examine him because I would get lost listening to his stories. He
would chuckle when I came back a few seconds after talking to with him, asking him
to give me some deep breathes. I would visit him each night before I left to
say goodnight and in a sense tuck him in.
When I went to see him in the ICU
after his tracheostomy, he smiled and seemed relieved to see someone he
recognized. Putting his finger over this trach, he talked to me awhile about
his wife. “We got married thirty years ago, and we’re still having fun. One day
when you get married, you’ve got to do everything 50/50. We make every decision
together.” Just as my heart started to melt, he quipped “Figure by my third
marriage, I’d finally get it right!”. I have a feeling Mr.B and my grandpa
would have been good friends.
After two weeks of caring for him, I
realized that I had mixed feelings about sending Mr.B home. Part of me wanted
him to be on his farm with his wife but the selfish part of me wanted to still
be able to drop by his room to talk. When I caught myself thinking of ways to
delay his discharge, I realized two things: one, that is a ridiculous thought;
and two, I truly feel a bond with this patient.
Our third year of medical school
may be coming to an end but our connections to our patients, family and each
other are just beginning.
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