As the hands of the large clock on the wall turn to 8 a.m, a wandering medical student strolls through the intricate hallways of the pediatric intensive care unit (PICU) at Nicklaus Children’s Hospital. Her eyesight shifted to various places in the unit as she struggled to find the so-called “fishbowl,” an office space where residents station themselves to work. After walking past the various rooms a few times, she was finally able to meet the providers she was looking for. That medical student, eager to save lives, was me. I was excited for my first day in PICU, hoping I could make a child’s day brighter. As I scrolled through the list of patients that we needed to round on, my attention drew to a very special patient. I was inevitably shocked when I read her diagnosis, realizing I would soon meet a young child with a rare neurological condition. There was no doubt that my first day in that unit would be one of the most heartfelt days in my medical school career. As I spoke to the residents, I became aware of how truly special that patient was. She had been in the PICU for several months because of the severity of her illness. Her perseverant organs were slowly failing one by one. Respiratory and cardiac failure were almost guaranteed. Her guardians no longer desired hospice care, but rather wished to keep her in the hospital instead.
She was next up in our list of patients to round on. For the first time in medical school, I felt scared to face my patient, doubting how I could meaningfully contribute to her care. As we walked into her crowded yet lonely room, an inevitable sense of hopelessness and despair made my heart ache. There she was, a beautiful, 8-year-old girl that managed to smile through her pain as she welcomed us into her room. We only spent a few minutes with her since medically, there was nothing else we could offer her except comfort care. We all knew she had a very limited amount of time left in this world. When I returned to the floor in the afternoon, I walked past her room and caught myself smiling for the first time that day. The nurses on the floor had prepared a princess tea party for her. I walked into her lively decorated castle and saw her dressed up as Cinderella, smiling for the pictures the nurses were taking. I felt an instant burst of joy that sought to overcome my previous feelings of sadness. She happened to be a fanatic of Disney princesses, thus we all rejoiced in watching her fairy tale moment. Little did I know that would be our last memories together. The next morning came by and I rushed to the ICU floor to visit my favorite patient. As I strolled through the intricate hallways of the PICU once again, a sudden mysterious silence filled the air that spoke of something not right. It only took a few minutes to find out what happened. My favorite patient had passed away. I thought to myself, “she is now in a better place,” attempting to lessen my sorrows. I had known her for only a day and half, but somehow her loss felt quite personal. It was a heavy day for those that became part of her family during the months she was there. I struggled to push through my day, but I knew the rest of my patients were waiting for me.
This is not the typical fairy tale with a happy ending. Instead, it depicts the real-life story of a third-year medical student who first experienced the loss of her patient. I was grateful to have witnessed her last moments of happiness and I thanked myself for taking the time to be there with her. I realized the time I can give now as a medical student to patients is a wonderful gift, one I may not have in the future. I also understood that comfort care can and may be the only type of treatment a patient may desire at a certain point in their lives. As I reflect on my experience with the eight-year-old Cinderella, I appreciate how she taught me patience, empathy, end-of-life care, but most importantly, how to move on with my day after a heartfelt loss in the captivating world of medicine.
Image credit: Butterfly Garden (4) (CC BY-ND 2.0) by L. M. Bernhardt
Contributing Writer
Florida International University Herbert Wertheim College of Medicine
Merlin is a medical student at Florida International University Herbert Wertheim College of Medicine in Miami, FL class of 2025. In 2020, she graduated from Florida International University with a Bachelor of Science in biology and Bachelor of Science in natural and applied sciences. She enjoys traveling, dancing, spending time with her family, and camping in her free time. After graduating medical school, Merlin would like to pursue a career in anesthesiology.