Perhaps the single most awkward conversation that a third-year medical student can have with an attending physician is the one that begins with the attending asking, “So, what medical specialty are you interested in going into?”
I float in an ocean of sterile cerulean. / In this deep of drapery and gowns, / One could swim out and never see the shore.
I wage war on you for you have let my eyes see; / I respect you, for you hold true to your decree. / But, I fight for those who lost purpose to your creed.
I strode down hallways, winding ‘round to meet / A sailor old and take to him his meal. / A gentle bounce in every step on beat, / This home to many always builds my zeal.
In high school, I was obsessed with wearing only vintage clothing. After hours of painstakingly searching every clothing rack at Goodwill, I would find a well-worn baseball jersey or an elaborately bejeweled Christmas sweater. I felt a sense of immense pride in reclaiming someone else’s memories — their winning games, their holiday parties – in an attempt to express my “uniqueness”.
We wield the privilege of the scalpel, / Slice skin, / Cauterize the cutaneous, / Disrobe the depths of disease.
The white coats and patient gowns that confer the implicit power dynamic of the physician-patient relationship are not to be found here in the operating room. This place has neither the tolerance nor the patience for this subtle symbolism. Here, on the other side of the Rubicon, the rules are stark, the stakes laid bare. The patient lies naked on the table, arms extended on boards, Christ-like, as the surgeon holds the knife handle and plays God.
One after the other, day after day it seems, I find myself in a room where the resident is breaking the news of terminal cancer to my patients and I feel an overwhelming sadness belied by numbness. It has only been a week and a half on internal medicine and we have already diagnosed three unsuspecting patients with cancer.
Last Saturday evening I was on the admitting team in Orange County. We got a call about a hematology/oncology admission that we would later pass off to another team in the morning. We were told “fever with an ANC <500.” That admit, was Ronaldo, a young male with acute lymphocytic leukemia.
An indulgent gasp / grasps the molded corners / dry tongue to chipping paint / searching for a word to say
In the rest of the house, the noise of the party is deafening: the clink of glasses, the sizzle of burgers on the grill, the excited cries of relatives reunited after long absences. But in the bright light of the kitchen, Mark is talking to me without sound. He presses his right hand over his left then moves up its length, separating his thumb from the rest of his fingers as he goes replicating the open and shut motions of a jaw. “This is the sign for cancer,” he says.
I’ve come to realize having an automatic word filter is one of my greatest blessings. It becomes quite useful when, in the middle of rounds, a patient’s single, monosyllabic response inspires such a flurry of mismatched curse words that only a properly formed filter can save my dignity. What exactly did this patient say that stunned me so violently? My attending had asked him a straightforward, albeit grim, question. “Do you know you have cancer?” …