Patient 15 was a fit 38-year-old female with a past medical history of dilated cardiomyopathy who presented for follow-up on her most recent echocardiogram results. Flipping through the past notes, prior echos, family histories, I was captivated. A previous echo revealed an ejection fraction of about 50% — her heart was already revealing its impending fragility. The most recent echo, just five months later, revealed an ejection fraction of 20% — her heart was failing!
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.
We sit in a clumsy ring / under fluorescent lights, / halfway into the allotted one hour / before we realize that we are having / a conversation born a whole decade ago.
It was a Saturday morning and there were close to fifty volunteers who gathered at a homeless shelter in Riverside, CA ready to give out hygiene care packages and offer free showers, haircuts, clothes, and food. Eager medical students and physician assistants provided free health care screening and visits. Efforts like these are fairly common — nothing groundbreaking.
For me, one of these moments occurred during my neurology clerkship, a week into working in the Neuro Intensive Care Unit (NICU). 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. All they understood about his condition up to this point was that Mr. R had a heart attack that led to some swelling in his brain.
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.
I began my journey with the Deaf community before coming to medical school starting with a basic American Sign Language class just to learn a few routine signs. I continued with the American Sign Language Club at Geisinger Commonwealth School of Medicine, hoping to learn more medical signs for any future interactions with Deaf patients. Through the club, I recently met an incredible four-year-old boy named John at a local community event to meet Peppa Pig.
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.
You were my first patient on my first inpatient rotation as a third-year medical student, which meant that I had absolutely no idea what was going on. I was mostly concerned with trying not to faint during presentations on morning rounds. I stared at your bowl of Cheerios, the cereal beginning to turn the skim milk a pale yellow. Your brow furrowed in annoyance behind your thick glasses.
A few years ago, I found CrossFit. Since then, I have spent a large share of my free time training and improving my health and fitness. As with any sport, there was a large learning curve. However, as I trained, my mind and body adapted. I made strides both athletically and mentally that I never thought were possible. I never imagined that this preparation and development would translate to a seemingly opposing task: medical school.
How could I study for my next exam instead of focusing my energy on the crisis around me? Was I selfish for still worrying about doing well in school while others died alone in the hospital on a ventilator? In these moments, I found respite in “Learning in War-Time,” a sermon delivered by C.S. Lewis to the students of Oxford in 1939 just as World War II began. In this timely sermon, Lewis addressed the chief concern on students’ minds: Why continue to study philosophy or science “when the lives of our friends and the liberties of Europe are in the balance?”
A first-year medical student’s stress and anxiety begin to take physical form as she navigates her first year of medical school.