It is morning outside, the sun barely kissing the horizon. The curtains have been drawn in an attempt to force any lick of light from the room. But one slim shard cuts through the drapes, illuminating John’s face. Or what should be his face, at least. He’s taken the slack out of the crisp, white hospital linen and holds it taut from his toes to his forehead. A backpack sits splayed open on the chair beside his bed, full of loose papers and tattered clothes.
“John?” I invite myself to stand next to his bed. “Are you awake?”
The hospital has a way of turning its visitors into light sleepers, and John is no exception. Just as I suspected, John is awake. He slowly loosens his grip on the corner of the sheet by his left eye. Once he recognizes the green glasses propped atop my half-masked face, he frees his entire head in one swift movement.
“You ask questions you already know the answer to, Sammy. It’s refreshing!” His mouth curves into a smile that creeps up from his mask and reaches his eyes.
I part the curtains and pull up a chair next to him, just as I did yesterday morning and the one before that. John has been in the hospital for three days, coming down from a PCP high.
On John’s first day here, I was unsure how to approach him. The internal medicine resident had all but warned me about this aggressive middle-aged man who was brought in for bizarre, erratic behavior outside an New York City subway station. “You don’t have to take on the new patient if you don’t want to.”
Whether a consequence of curiosity or overconfidence, I walked into that room without hesitation. It was just a couple of weeks into my first clinical rotation, and I was ready for any opportunity to learn and, hopefully, impress. But when I entered his room, it dawned on me that I had never encountered a psychotic person before.
“Good morning,” I said quietly, just barely audible above the beeping monitors in neighboring rooms.
“Angel dust,” John told me when I asked him why he was brought to the hospital.
“I used to never feel. Then when I started to feel again, it all caved in and I started using drugs to feel detached again even though I hated it.” He stopped.
“I’m sorry,” I began, unsure if these were the words he wanted to hear.
“You ever feel like that? Alive but numb?”
A beat of silence passed as I sat in thought before my vision was blurred by tears. I hesitated to say anything, wanting to maintain a level of professionalism with my patient. But as I saw him looking back at me and waiting for an answer, I noticed his eyes started to glisten too.
In this moment, the façade I was meant to keep seemed far less important than this patient — this person — who was unmistakably calling out to me for connection. I nodded, tears beginning to soak through my mask. “Yeah,” I finally said. “I know what you mean.”
Soon I heard the rest of his story, going all the way back to his twenties. John had lived countless lives, and I was privileged to be sitting across from him in this one. He reminisced about his time as a chef and then as a tattoo artist, his tools of choice a knife or a needle. He was not so different compared to back then. But now twenty years later, he used the knives and needles as weapons against himself.
We took a moment to just be before I asked to perform a physical exam. Our tears eventually dried up, but the connection I formed with John would underlie each remaining interaction I had with him. He confided in me stories that no one else on the team would ever hear.
I think about that first conversation as I sit across from John now. He speaks to me with a level of candor that no one else on the team managed to unlock. He calls me his guardian angel every morning since our first meeting. I see that John embodies quite the opposite of everything the medical team warned me about. Far from unpredictable and accusatory, he is gentle and careful, even from day one. “I can tell you have beautiful energy.”
Somehow, I was able to persuade John to try to at least be friendly with everyone else on the team. He didn’t trust them as he did me, but all the hospital staff were no longer getting yelled at or accused of stealing his breakfasts. Not long after, he was sober and ready to be discharged. He told me all about his plans to visit friends across the boroughs and the steps he would take to keep himself safe, sober, and “away from the wrong crowds.” John left that hospital empowered to change the trajectory of his life for the better, but he also left me empowered to always choose vulnerability and connection with my future patients.
As I make my way through medical school and into the next stage of training, I will keep John, and many other patients whom I have had the privilege of serving, in the back of my mind. I always knew that health care providers change the lives of their patients, but I never expected patients to change my life just as much. Taking the time I have now as a medical student to listen to patients’ stories builds my patients’ trust in me as their provider. I make them feel comfortable enough to share the information I need to know so I can best serve them. When I make space for patients to share their voices, they have the chance to process the emotions surrounding their illness; on top of that, showing up for them in that way enables me to process my own too. Each of my patients has allowed me to grow in my capacity to practice empathy, patience, critical thinking and effective communication — to hone the skills we need to encourage healthy living.
In a time when patients and doctors alike have increasing priorities and less time for health visits, it is easy for patients to feel like entries in a long list of medical record numbers. Larger patient volumes may yield more profit, but we cannot lose sight of our obligation to provide high-quality care in the time we are allotted. To do this, we must form and maintain meaningful connections with our patients and not let prejudice diminish our respect for their humanity. A connected life begins with tearing down the walls of cold stoicism and continues with building up one another, not in spite of our vulnerabilities but because of them.
Author’s note: Patient’s name and details have been changed to maintain confidentiality.
Image credit: Sunrise through the curtains (CC BY-SA 2.0) by quinn.anya