I worked my last shift in the emergency department as a medical student last week. A few hours in, I walked to the chart rack and grabbed the next patient to be seen.
I walked into the room in question and introduced myself in that fluid, simple way I’d perfected over thousands of encounters over the previous few years. “Hi, I’m Sarab Sodhi, the fourth-year med student on the team. What brings you in to see us?” And I started listening. The meticulously dressed, distinguished, patrician gentleman in the room told me his story between gasps for breaths with occasional help from his daughter and son.
It was a pretty straightforward case. This gentleman had a history of heart failure, and he needed a medication to keep fluid off his lungs. However, he also had bad gout and there was a strong chance that his heart medicine was making his gout worse. So his gout doctor took him off the diuretic that kept him breathing easily to control the gout. A few days later, he was in the ER with trouble breathing. Needless to say, this wasn’t a case that really forced me to tickle my brain cells. So five minutes later having spoken to him and examined him, I left to run the tests I wanted by my attending.
We ordered his tests, and they came back a bit abnormal. His lungs also hadn’t improved much in the intervening hour or so and we weren’t comfortable sending him home with continuing trouble breathing and abnormal labs so we sent him in for observation to ensure he had his low blood count worked up.
I went in and told him what we were thinking from his labs. He was alone this time, his son and daughter had gone to make some calls.
As I told him what we were thinking, I saw in his eyes an expression that for a lesser man would have been a moan of mental anguish. He looked away from me, and in a forcefully steady voice asked me why he, who had lived a spartan, healthy lifestyle and survived some of the bloodiest days of World War II, was going through all of this now. I answered, as best I could, explaining that age had caused his heart to beat in a faulty (but common) way that made him more likely to have clots, which made him have a heart attack that caused his heart failure.
Explain as I did the science, I could see it wasn’t helping.
So, instead of relying on the science of medicine, I relied on the art of medicine. I told him a story about my grandfather. My grandfather, the former brigadier general who had developed the same heart condition, had a stroke and been admitted to the hospital. My grandfather, who hated the hospital, and only agreed to go to it when I was home. As I told him that, his eyes lit up a little. He began to tell me of his career as a staff sergeant in the Army, about the bloody battles of World War II he’d been paradropped into, and his family. I sat there and listened. I listened for a good ten minutes until I heard a code called over the PA system. I apologized to him, as he waved me off with a smile saying, “To the trenches, doctor!”
I ran out of his room to the trauma that was a few minutes out. As I put on my gown and gloves, I realized that while my patient and I had shared a moment, he, like the many others I had helped in the emergency department, would never remember my name. I wasn’t going to be the family doctor who got a Christmas card every year.
I worked in a place where none of my patients would remember my name, and that’s okay. Because, you see, I remember theirs and their stories. And for me, that’s enough.
The Fourth-Year Faux-cisian deals with the trenches of medicine, the dirty details and the inglorious scut, as well as with the sublime and transcendent moments. The posts I write are about medicine, humanism, life, philosophy, and most of all the ruminations of a young doctor-to-be as he embarks upon the transformative journey of becoming a physician while attempting to hold onto his humanity.