Contributing Writer
Herbert Wertheim College of Medicine
Daniel is a third year medical student at Herbert Wertheim College of Medicine in Miami, Florida class of 2023. In 2017, he graduated from the University of Florida with a Bachelor of Science in psychology. He also is a licensed EMT in Florida. He enjoys watching sports, trying new foods, and exploring nature. After graduating medical school, Daniel would like to pursue a career in emergency medicine and eventually health policy.
Every medical student has felt apprehensive about facing death at some point, right? Maybe you have experienced someone dying before, or maybe it is something you have never seen and only rarely contemplated. Regardless, there is a subtle tension lurking during your first two years of pre-clinical studies, during which disease and death are intellectualized and abstract. Then clerkships start.
Uvalde / I hear the cries of children as they play at the school across the street / They are joyful and exuberant as they play in the Texas heat / unaware of the fear that will soon be unleashed
Tears for the dead, tears for the living / who persist in this world that is so unforgiving
Big procedures can be tense, but today’s felt a little different. The atmosphere was relaxed. Then, unexpectedly, a few issues arose. Two of them, to be precise.
This drawing depicts the stark contrast of a woman who is both strong, yet visibly vulnerable as her tears pour off the page. This piece was inspired by a patient who was admitted after an incidental finding of a lab abnormality, which forced her to stay in the hospital for four weeks. When she initially learned of her lab results, she was overwhelmed.
As she closed the door behind her, the palliative care geriatrician whom I (Meghan) was shadowing turned and said, “Remember, there are no difficult patients – just difficult situations.” We walked to our next patient, Mrs. C, who was suffering from congestive heart failure. All cures had been exhausted and she was tired of being at the hospital but was scared to enter hospice care. The doctor clasped hands with Mrs. C and explained that starting hospice did not mean giving up – it meant living life on her own terms in the time that was left. After these discussions, Mrs. C appeared more at ease and decided to pursue hospice care at her home.
As I unzip the synthetic shroud, / he breathes his last, first breath: / one final exhalation from the plastic pleura / before we make acquaintance.
Nineteen. Oh the joy of being 19 years old. Can you remember back that far? Reminisce on the butterflies you felt as you waited for your date to pick you up for your very first college party.
Why — why did you die? / Your soul took to the sky / without a conscious goodbye
There is a fine line between medicine and mortality: give too much and it can kill someone; give too little and even that could kill someone. We show up to the hospital with the intent to save lives, and anything that deviates from that goal is seen as a failure of the system, or, at times, of ourselves. However, over time, we come to learn that there is an in-between where we are at once trying to preserve life, all the while embracing the idea of human mortality.
In the pediatric ICU, a call was received from another hospital to give sign out for a patient already en route. The child being transferred had experienced a traumatic brain injury. The child was intubated after receiving every sort of therapeutic management imaginable in a desperate attempt to salvage any remaining brain function, but the prognosis was dire.
With a growing interest in geriatrics, I began to wonder what resilience looks like for elderly patients, who unlike children, present their life trajectories to physicians much later. This is perhaps challenging and even uncomfortable to discuss for those who perceive resilience as a long-term goal — overcoming significant barriers in order to improve over time. Resilience may not seem as relevant for elderly patients who may be nearing the end of their lives.
Contributing Writer
Geisel School of Medicine at Dartmouth
Bo is a fourth year medical student at the Geisel School of Medicine at Dartmouth in Hanover, NH class of 2024. In 2018, Bo graduated from Dartmouth with a Bachelor's degree in psychology, then pursued a Master's in global health at UCSF. Bo enjoys running, hiking, and volunteering in her free time. Bo would like to pursue a career in internal medicine and geriatrics.
