Writer-in-Training
University of Illinois at Chicago College of Medicine
Currently an M2 at University of Illinois at Chicago College of Medicine. Interests include global health, health disparities, and emergency medicine. Also enjoys photography, classical music, travel, and medical history. Will work for dessert.
Everyone at the nursing station turned silent and looked at the nurse who had delivered the news. I looked at her in disbelief, my brain struggling through a fog of confusion and surprise. I squinted at my patient list trying to remember who was the patient in 1152. Recognition finally hit and I remembered the little old lady that we saw during rounds two hours ago.
I took the first cut / And suddenly it hit me … A wave of emotions / At once exhilarating, at once terrifying
Seeing this dialog box, which pops up on the hospital’s electronic health record program, is never a surprise. On the list of patients whose charts I’m supposed to review for my summer research project, the deceased ones are highlighted in grey, setting them apart from the otherwise black-and-white list of names and medical record numbers.
White gloves on black skin. The fingers of my gloved hands still interlaced, still resting tensely over her sternum. Elbows still locked. Frozen in the position endlessly refined during CPR training. It turns out that blood flow is important for catheter angiography, which presents a challenge if your patient has no heartbeat. Has not had a heartbeat for 45 minutes.
I am doing flashcards almost rhythmically, rocking my chair and thoughts to the lilting cadence. It’s early, and my fingers are curled around a steaming coffee. I move forward through the deck, slotting each pearl of information into my brain as best I can, until one prompt jolts me from my focused state.
I could see the scythe swinging from one eye to another / The Reaper hovered towards my room / Life had left me months ago, when I had first heard the news / Now I knew it would’ve been better, had I not left the womb
Have you ever had a sinking feeling in your stomach when you are about to tell something to a patient or family member that might change their life forever? I had that feeling before speaking to the wife of my patient, Mr. Smith. It had only been one day since Mr. Smith was first admitted to the inpatient unit but regardless of how long the interaction is with a patient and their loved ones, some news is always difficult to deliver.
Somehow I managed to complete a full year of clinical clerkships without bearing witness to a patient’s death. This seems like a marvelous and lucky thing, and it is for all the patients whose care I played a role in over the past year. However, this might not be such a great thing for me, as a future clinician. Medicine is two parts science and one part humanity. The science part can be read in journals and learned from books, but the humanity part is learned by experience.
a nightingale knows best. / her call comes forth / as the daylight dwindles, / and, listen… i hear her now.
In today’s America, it is well documented that each year, more of our GDP is being devoted to healthcare spending, and a disproportionate amount of that healthcare spending is towards end-of-life care. According to a 2013 report from The Medicare NewsGroup, Medicare spending reached about $554 billion in 2011. This was 21 percent of the total spent on health care in the US that year. About 28 percent of that $554 billion — $170 billion — was spent on patients’ last six months of life.
We stood in the shadows, a staggered line of nurses, students and surgeons in matching blue scrubs and masks. It was the middle of the night. Our tired bodies sagged against the walls, our bloodshot eyes dancing between the clock above and the gasping life below. A young man was dying in the operating room. He lay on the cutting table with his arms splayed wide, like a martyred saint stretched upon the cross.
The old woman with long silver hair sat in her wheelchair, feet propped slightly up, smiling toothless among her layers of wrinkles. She waited for me to speak, deferring her decades of matriarchy and adulthood to the stethoscope I wore so casually after just months of earnest experience. Indeed, it sat lightly on my neck today but heavily on my heart. A few more seconds passed, as I contemplated how exactly I wanted to discuss her test results and how exactly I would ask her to proceed.
Contributing Writer Emeritus
Yale School of Medicine
Lorenzo R. Sewanan grew up in Paramaribo, Suriname, and moved to Queens, New York, when he was sixteen. After graduating from Trinity College in physics and in engineering, he enrolled in Yale School of Medicine as an MD/PhD student. As a child he used to invent worlds of imagination, and now, he wants to bring inner worlds, his and others, to papers and words.
