Contributing Writer Emeritus
University of Pennsylvania
Matt Trifan is a current resident of emergency medicine at Thomas Jefferson University Hospital in Philadelphia. He was a former medical student at the University of Pennsylvania. In his free time, he reads, writes, travels, and never misses a chance for brunch. He owes his life philosophy to Albert Camus and Adventure Time, equally.
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.
There is a white ball of yarn that rests on the chair beside me. I drag the free end, extend the thread and wrap it around the knitting needle to begin my stitch. I think I’ll try to make a scarf until my husband tries to speak again.
This beating heart / Gave me a second start / It gave me a reason to be / To be me
The beginning of third year clerkships is an exciting time for medical students. The first step of my licensing exam was finally behind me and now I could focus on applying the knowledge into a clinical context. I had heard a lot of stories about the third year of medical school. Perhaps what stood out most were the reflections shared with me when people witnessed death for the first time. From full codes to hospice patients, something about death seemed to draw out the most intense emotions and thoughts that can change lives forever. Although I always try to do the best for my patients, I knew it was inevitable that I would come across death. I wondered what profound thoughts and reflections I would have when I experienced it for the first time. It wasn’t too long before I was called to do CPR in the emergency department and I found it did not play out as I expected.
They’re out of place in dirty Crocs and wrinkled sweatpants. More notably, she’s wiping tears from puffy cheeks. It’s a sharp contrast to the nurses, who are too casual. One makes a remark to the other about a tangled tube. They always get that way. The other chuckles.
Like many bibliophiles, I keep a running list of books “To Read”, and I have a complicated system for deciding what I will read next; because of this, any new recommendation must go to the end of the queue. Every now and then, though, a book comes along that disrupts my whole system. In this case, I read an excerpt in The New Yorker that moved me: I was struck by the clarity of the writing and finished the excerpt wanting to know more. Over the next week, three different people recommended it and I began seeing it everywhere. Sensing that this book was something important, I bought and immediately began reading When Breath Becomes Air by Dr. Paul Kalanithi.
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.
Normally I’m itching / hustling / to be involved in a delivery.
I climbed into bed on October 11 excited: for the first time in years, I could pinpoint what I was feeling — I was happy. Pure, simple happiness, something that had eluded me for years in the throes of depression and anxiety as a teenager, was a feeling I could recognize again. Wow, I thought, maybe this will be my year.
Although there is really never a right time to die or even witness death, it is important to acknowledge that death is a reality, and one to which all health care practitioners will be subjected at some point in time. For that reason, I raise the question: is there an appropriate time to lose a patient? From my perspective the answer is yes, and for good reason.
Young eyes awake to a febrile surprise / amid a quake of jittering limbs, / a clonic fit whose master cried / and shook the serenity of his crib.
Medical Student Editor and in-Training Staff Member
Albany Medical College
Steven attends Albany Medical College as a student of the Class of 2017. Raised in Queens, New York, he earned a BA in English with a minor in Biology from Binghamton University in May 2013. Some of his interests include poetry, martial arts, traveling, and continental philosophy. He is currently aspiring to become a radiologist.
