In medicine, it is often much easier for a patient to remember all of their individual doctors than for a doctor to remember the face of every single patient. There are too many patients to commit to memory, especially as a medical student. We usually do not have the luxury of continuity of care to see patients more than once in their healthcare journey.
I would be lying if I said I remember every single patient that I have seen in the past almost two years of clinical rotations. However, each of my core rotations has become defined by one or two patients that most stood out to me.
My first rotation ever was spent on a vascular, endocrine and breast surgical service. A 50-year-old woman defined this experience for me. Though my interaction with her was brief, I won’t soon forget her smiling face on rounds the morning after her surgery. She had just undergone a double mastectomy followed by bilateral deep inferior epigastric perforators (DIEP) flaps.
Although she had undergone hours of surgery and still had a long road to recovery, she exhibited such warmth and hope every morning when I woke her up, even at 5 a.m. I had been shocked to be received with such enthusiasm, especially after observing the surgery and understanding how taxing it must have been on her body. When I commented on how upbeat she was, I was told “I’m here and I’m happy to be on the other side of this.” That optimism was a great start to my medical rotations, a moment I still remember during the harder times.
While many of the faces I remember are associated with positive experiences, the face of Neurology comes with a more somber memory. In Neurology, not all patients are conscious and the idea of a patient I couldn’t talk to made me slightly uneasy. I couldn’t imagine trying to gather information from someone who couldn’t verbally convey their problems. However, that is exactly what I was faced with on day one when I encountered a comatose patient.
In search of an answer to his inexplicable coma, the team performed a lumbar puncture to look for a possible infection of the brain. My job was to hold the patient on his side while they worked at his back to collect the sample. I stood by his head, rubbing his shoulder in comfort, as tears streamed down his grimacing yet uncommunicative face. We were trying to get the information we needed for our answer, and he could not tell us to stop, even if his face clearly said he wanted us to. It was painful to watch, but an important reminder that not everyone can express what they need or feel. As a physician, I will encounter many patients who may not be able to verbalize; this doesn’t mean they won’t need me to be listening. I learned from this encounter that body language, facial expressions, physical deficits or emotional outbursts can say just as much as words.
Being my sole rotation that was fully outpatient, family medicine is a face that is harder to remember. Each interaction was so brief that forming a connection was more difficult to accomplish. I recall most the middle-aged man who started off by telling me I had the same name as his daughter. He asked how I spelled Sara and we both agreed that the “correct” spelling is without the “h.” Short and simple, but a connection nonetheless.
While many connections on this service were brief, they showed me how even the smallest communication can create a positive experience. An early alliance can make the visit more enjoyable for everyone because it starts you off on the same page as the patient. A brief visit with a healthy individual may be one of the only interactions they have with doctors for several months to a year. To me, it is one in many interactions of the day but for them it could be what defines their current perception of “medical care” and how likely they are to trust their physicians when things go wrong.
Internal medicine was a difficult rotation for me since it was filled with so many sick individuals. But one stood out from the rest: an elderly man with congestive heart failure. He had a heart pillow that he was always hugging, but he was there because his heart was not properly doing its job. I can still picture him, frail and puffing to breathe through the fluid backed up in his lungs. It isn’t difficult to picture his wife as well, dutifully by his side every morning.
While she knew I was “just the medical student” on the team, she trusted me to always tell her the truth because I wasn’t “just” anyone to them. I answered their questions about new medications and possible discharge dates. Despite their predicament, the two of them made me feel like a part of the family. They often showed me pictures of their kids, grandkids, and pets. Walking in every morning was a high point of the day because I knew they would always put a smile on my face. As a medical team, we stabilized his heart as he filled ours with love.
For pediatrics, there is not a single face that stands out to me but two people: the wheelchair-bound child with permanent brain damage and his father that inexplicably broke my heart on one particular day. Nothing sad happened during the visit, but waves of emotion crashed over me as my heart went out to the patient’s single father. He had no extended family; it was just the two of them. The seven years worth of wear from taking care of a son with neurological deficits secondary to a brain injury during “birth trauma” was clear on his face.
Yet, in that same face, I can recall the pure love he had for his son. His son could not walk or talk but that father showed true devotion. Something about the tender way he put his son into his wheelchair and pulled up the hood of his son’s sweatshirt and poncho created a lasting image. It was a raw expression of unconditional love that I won’t soon forget.
Of all the faces I remember, OB/GYN is the face I hope may remember me too. Worried I would miss the delivery of my patient, I stayed with her for the last four to five hours of her labor, helping every step of the way alongside the nurse. I helped hold up her legs during contractions and gave words of encouragement during her periods of rest. During some of these brief interludes of calm, I simply talked to her and her husband about their soon-to-be daughter’s name and about my time in medical school.
After almost requiring a cesarean section, she successfully had a vaginal delivery. I stayed late to see her through to the end, feeling just as thrilled as she was when her daughter was finally born. I will often wonder how her daughter is doing. A small part of me hopes that she remembers the medical student who was there as she gave birth to her first child.
Emergency medicine is filled with a myriad of faces, old and young. The one that stands out the most is the young man who came in for stitches at about 4 a.m. The young man in question was a college student who had been out on a Friday night, doing stereotypical college student things. Somehow he had both broken a drinking fountain and cut himself on it. As a result, he required nine stitches.
I especially remember the look on his face when the attending told him I would be stitching his arm. I had sutured in the operating room several times but had never done so on a conscious patient. Luckily, I was able to assuage his fears and talk him through my steps in the process. I’ll never forget that momentary look of panic when he realized I would be closing the wound or the look of amazement mixed with relief when the wound was fully closed and covered up to heal.
Finally, we come to psychiatry. I could write all I have above and more about the faces of Psychiatry. I can’t pick just one. At this point in medical school, I have made a profound connection to too many patients to feel justified in only defining one. The 16-year-old girl, the 13-year-old boy, the 21-year-old young man, the 30-year-old man, the 60-year-old woman — the list goes on with all sorts of people, young and old. It wouldn’t be fair to only talk about one, because each patient means so much to me.
To adequately treat their psychiatric complaints, I often learn things about them you don’t learn about many other patients. These have included their relationships, their childhood experiences, their work life and their innermost thoughts. All these details make the memory of them so much more well-formed. The connections I have with these individuals and the depth of those connections are too profound to put into words.
Whether it is because they taught me something important, connected with me in some profound way or just said something simple that has stuck with me, these are the faces of medicine for me. These are the patients I will never forget.