Columnist
School of Medicine at Trinity College Dublin
Fiona Doolan is a 4th year medical student at the School of Medicine at Trinity College Dublin, Dublin, Ireland, graduating in 2023. She holds a B.S. in physiology from Boston University, 2017. She is host of the podcast CXR: Careers x Radiology. CXR is a long-form interview podcast introducing radiology to the medical student. It was inspired by the explosion in virtual connectedness worldwide during the pandemic, and from a deep curiosity about the specialty. Fiona is an avid runner and aspiring radiologist.
Write Rx
Now and for the foreseeable future, providers and patients wear masks. An essential element of the doctor-patient relationship – nonverbal expression – is much reduced. When what is on our faces is anathema, we rely more heavily on narratives. Consider each entry of ‘Write Rx’ a prescription for a narrative medicine exercise that just might help you find the right words to relate to patients in this changed space. Here I hope you will find a bit of inspiration for reflection amidst the rigors of medical school, not in the least thanks to some famous physician-writers, excerpts from whom serve as an entry point for each exercise.
My interest in radiology began, as it does for many, with the thrill of coming to a solution based on imaging and some sparse words on a patient’s chief complaint. Reading radiologic scans is like learning a language — a code composed of axial and coronal views, enhancing and nonenhancing areas and anatomical landmarks. When you dive into the millimeter slices of a contrast CT and the defect snaps to your attention, you are hooked.
“This one is a handful. She brought a long list, too, so good luck with that,” the nurse said as she handed me the patient prep sheet. This was a new patient to the family medicine practice. I was seeing her near the end of a long day, so I took a deep breath to reset my mind as I entered the exam room, prepared to listen.
I knew she was in a difficult legal situation that was taking an emotional toll on her. After learning that she had few visitors, I asked about her depression and how she was coping. As she spoke, I could not help but think about the degree to which her social isolation was worsening her symptoms.
What happens after a nurse has gained valuable experience at the bedside and fine-tuned this skillset? Many find themselves exploring the idea of returning to school for an advanced degree, which is typically a master’s degree or doctorate in nursing. On the other hand, some choose to take a path less traveled — from nurse to physician.
“I have good news for you,” my resident exclaimed as she walked into the exam room. She was holding the patient’s most recent vitals handed to her by a nurse practitioner.
My first patient with Alzheimer’s, Sheryll, led me on a journey of questions and self-growth which I had never expected. Until meeting her, I hadn’t thought extensively about how our biology may dictate cognition and free will. While my thoughts on the matter continue to develop as I broaden my clinical experience, these considerations continue to frame my understanding of my patients, myself and the world around me.
It was obvious that something was off. His mood was not what I would expect from a patient who had received a transplant, which for many patients represents a second chance at normalcy and freedom from the restrictions of dialysis. As we started our trek out of the SICU, my attending continued to tell me Mr. W’s story.
I learned English out of necessity — not only for myself but also for my family. I grew up in Mexico and moved to a small Northern California town at the age of eight. When we moved to the United States, I was placed in an English-speaking classroom with no one who spoke Spanish. Necessity forced me to learn English quickly and, as a result, I became my family’s unofficial interpreter, including at their medical appointments.
Before starting medical school, buried in a list of to-do tasks, I was asked to submit my Meyers-Briggs personality inventory. I was no stranger to this string of four letters, as I had performed the assessment many times in my life. I didn’t need to take the test again to know what I would get: INFJ.
Dr. Ely’s research has focused on improving the care and outcomes of critically ill patients with ICU-acquired brain disease. His team developed the primary tool by which delirium is measured in ICU-based trials and clinically at the bedside in ICUs worldwide.
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.
“Abuse is of use.” / That is what we tell ourselves. / That it makes us stronger.
Medical Student Editor and Contributing Writer
East Carolina University Brody School of Medicine
Holly Ingram is a fourth-year medical student at the East Carolina University Brody School of Medicine in Greenville, North Carolina. In 2016, she graduated with a Bachelor of Science in biology with minors in chemistry and anthropology from the University of North Carolina at Chapel Hill. In her free time, Holly enjoys playing soccer and visiting waterfalls. After medical school, Holly would like to pursue a career in pediatrics.
