Hospital Doorstep
A man sleeps in the sun on a bench across from the hospital. On the bench diagonally opposed, across and beside him, an almost-doctor eats cold noodles.
A man sleeps in the sun on a bench across from the hospital. On the bench diagonally opposed, across and beside him, an almost-doctor eats cold noodles.
In the extremely efficient and fast-paced environment of health care, the emotional needs of patients and their families may become secondary to their medical treatment plan. But emotional stressors may be directly associated with poor outcomes in regards to the healing process and overall quality of life. Thus, these needs may be addressed by face-to-face communication that allows for better patient education. Such investment of time is most rewarding when both the patient and family members have the opportunity to explain their fears and worries regarding treatment.
In the neuro intensive care unit, I took part in a meeting with my team to update a family on the status of their loved one. It was my first time in this type of meeting, especially for a patient that I was directly involved in caring for. To our team of medical professionals, he is our 51-year-old male patient with a 45-pack-year smoking history, but to his family, he’s a son, a husband and a father.
My friends and I wished we knew how to flourish from the beginning, so we decided to create Wards & Boards, a peer-to-peer mentorship mobile app. The app compiled advice from fourth-year medical students who completed each clerkship designed for third-year students beginning their first rotation.
This piece is focused on the applications of empathy and compassion in decision-making. How can we distinguish between them? In its simplest form, empathy deals with feelings while compassion deals with understanding.
I actually don’t remember his name; he wasn’t my patient. I just saw him during rounds every day during my internal medicine clerkship. He was in his late-80s, and he was very ill. He had a long history of COPD, most likely attributed to his even longer history of smoking. He had been admitted to our service for a severe respiratory infection a few days prior to me starting the rotation. This was my last rotation of my 3rd year, and I walked in thinking I had seen enough COPD patients to know exactly what to expect.
Mr. K had been admitted with dehydration and malnutrition secondary to diarrhea in the setting of HIV. During his stay, he developed refeeding syndrome. When the resulting electrolyte imbalances paved the way for cardiac arrhythmias, he coded twice in the ICU. The care team managed to bring him back each time, but not without consequence; the brutality of numerous cycles of CPR left him with multiple rib fractures, inflicting him with sharp pain every breath.
A scalpel, a corpse — / His beard is neat, his eyes are / Empty. Gloves hide clammy hands / Afraid of what awaits beneath
You don’t have to sit in silence and painfully nod along with an attending’s racist, misogynistic lectures because you’re their medical student. You don’t need to pick the skin off your cuticles to stop yourself from replying. You don’t need to learn how to hide your grimaces behind your mask because you know you’ll have to listen to them attack your identity for the next several weeks.
Each morning, Mr. E had a new concern — too hot, too cold, too dizzy, too stiff. He was admitted for what seemed to be a straightforward heart failure exacerbation, but his echocardiography showed severe hypertrophy in both sides of his heart that the cardiologists described as “concerning for infiltrative cardiomyopathy.”
Unmotivated to study, I dedicated myself to researching the virus as well as its epidemiological, social and economical impact on our communities. Adjusting to life in quarantine was frustrating, and I felt like I was watching the world turn upside down. However, researching the pandemic felt much more relevant than trying to use all these anatomy apps to fill in gaps created by a lack of practical hands-on learning.
I knew I moved through these spaces easily for many reasons, but being White is a big one that needs to be said out loud. And when you look and feel more comfortable in a space, it is easier to perform “well,” or to sound confident. This is directly related to what academic medicine characterizes as “objective” evaluations of students, and there is data to support this.