From the Wards
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But The Laborers Are Few

“Well, what should we do for this patient?”

I started violently, perceiving to my chagrin that I had zoned out on rounds again. My heart knocked against my rib cage before I realized to my relief that the attending was pimping the intern for the answer, and I was not under the interrogation light. I delicately turned my sudden startle into a hair-tuck behind the ear, desperately hoping the look of hunted prey had disappeared from my face and forced myself to pay attention. As we stood, I shifted my weight in my shoes and thought about what I should eat for dinner, then realized that my mind had again wandered from the subject of our huddle. To my horror, I realized not only did I not know what we should do for this patient … I didn’t even know which patient we were referring to.

Glancing across the group, I watched my fellow third-year listening intently, and I wondered why I couldn’t do the same. The desire to impress, to compete, to prove myself to this attending whose admiration I desired and whose respect I hoped to garner by the end of the internal medicine clerkship won over the idle ramblings of my sleep-deprived brain. I squared my shoulders and tilted my head to the side quizzically as if caught in deep and perplexing analysis of the case. I was determined to look the part of the astute student, in the hopes that one day I might wake up and realize that my act was in fact reality. I succeeded for about 30 seconds.

My gaze had wandered across the heads of the team to a man standing by the elevator. He looked to be in his 30s. He had a short build. He was wearing Bermuda shorts and a t-shirt with red and white stripes. And he was crying.

I averted my eyes instinctually. Most of us know what it is like to cry in public. We pray that people will have the decency to ignore the very obvious streaks on our faces, because we think that this is the best approach to helping us forget the cause of our grief or our own unseemly public displays. I tried again to focus, focus please, on the patient the team was discussing, but I again found myself looking at the man. He was slumped against the wall near the elevator, holding a cellphone and talking softly into it. For a moment I thought he was collecting himself — rallying the troops, so to speak — until I saw a fresh wave of tears running along the rivulets left behind by their predecessors. I only saw them for a second before his hand moved quickly to cover his face. He began to pace in small circles, still weeping softly while pressing the phone to his ear.

If you have ever been in a hospital hallway, you know it is not a quiet place. Yet for some reason, this man’s grief was deafening to me. I racked my brain for the reason: Bad news, maybe bad news, maybe cancer? We are on the cancer ward after all. Maybe death! Had someone died? Maybe his mom? His wife? Heaven forbid a child…

My agitation grew as I realized I needed to do something, that I should do something. I was a medical student training to be a doctor after all, right? Wasn’t I supposed to help alleviate the burdens of others? Wasn’t half my job to listen? Yet I stood still. Completely still, my feet cemented into the linoleum just as surely as if I was a wax figure without mind or conscience or will.

My line of questioning had seamlessly taken a different course as I stood frozen, my gaze still fixated on the grieving man. What about the team? It would look so bad if I just wandered off as if I hadn’t been paying attention. Well, I haven’t been paying attention, but then I’d be making it obvious. What kind of impression would that leave? What would the attending say? The four week block is almost up, I don’t even know if he remembers my name, but I don’t want him to remember me badly … What if —

A stir of movement at the group’s edge distracted me from my internal barrage of questions. I watched, speechless, as my colleague — same team, same attending, same subordinate role in the medical hierarchy — stepped away from the huddle and walked towards the man by the elevator. I watched as he stood by the man, clasped his hands together in front of him and asked the man a question. My colleague — we’ll call him Jordan — was tall, almost a full head taller than the man, so he had to stoop his head to hear the response. Jordan then put his arm around the man’s shoulders and said a few words. They could not have been more than one or two sentences; I strained and strained to hear what was said, but in all honesty the content was of little importance. The man nodded, and Jordan lowered his arm after giving him a small pat on the back. Then Jordan seamlessly rejoined the huddle, just as surely as if he had never left.

He had strayed from the group for all of 45 seconds. No one had called the dean of the college of medicine to report his absence. The attending had not spouted a tirade of verbal abuse against Jordan’s decision to walk away from the huddle. None of our patients had suddenly coded prompting a team member to suddenly ask, “Hey, where’s Jordan?” No one stood speechless at this obvious act of insubordination; in short, the world had not ended. The only person who stood speechless and in awe … was me.

We live in a world defined by the axiom that “time stands still for no man.” Our lives are a bustling whirlwind of events taking us from point A to point B and back again, and we think our purpose is realized when we achieve this movement rapidly, efficiently and without distraction. I truly thought that I was accomplishing my goal, my purpose, by ignoring the distraction and performing my task. In reality, the distraction was my task. That man was my task, that man was my purpose, and another more genuine individual recognized it before I did.

To this day I still do not remember the management for the patient being discussed by the team. I do not remember the patient’s diagnosis or even the patient’s name. But I do remember the man by the elevator and I remember Jordan. I remember Jordan … because he did not hesitate to step away from the huddle.

Tryphina Mikhail Tryphina Mikhail (1 Posts)

Contributing Writer

University of Central Florida College of Medicine

Tryphina Mikhail is a third year medical student at the University of Central Florida College of Medicine in Orlando, FL class of 2021. In 2016, she graduated from the University of Central Florida with a Bachelor of Science in biomedical sciences and a minor in health sciences. She enjoys crocheting, playing volleyball and lindy hop swing dancing in her free time. In the future, Tryphina would like to pursue a career in primary care and academic medicine.