Tears for the dead, tears for the living / who persist in this world that is so unforgiving
Today, I am determined to notice love.
One of the most impactful influences on my decision to become a doctor was meeting a patient with multiple sclerosis (MS). I was 19 years old and a hospital volunteer in Michigan. As I was replacing gloves, gowns and towels in my department, I entered the room of an elderly Eastern-European woman.
There I was, face to face with a middle-aged Korean man, blood still dripping from a gash in his forehead. Disoriented, erratic, agitated … and rightfully so.
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.
Lots of people get bigger bellies as they age. My aunt used to say it was because of all the love in your life building up. This man noticed his belly was growing a little more than expected.
Freud supposedly understood himself as a surgeon of the mind, dissecting his patients’ mental anatomy through the process of psychoanalysis. I found this comparison appealing, so when I started the psychiatry clerkship in my third year of medical school, I approached the interview in psychiatry as analogous to a surgical procedure — efficient, scripted, precise.
Mr. T did not smile at me. No, I didn’t think it was because he was mean or anything; in fact, he was polite and had quite a calming voice. But honestly, it was hard to read someone’s facial expression behind a mask — at least during the first few months of the COVID-19 outbreak.
“I’m sorry that you have to see me this way,” said Ms. A as we exited the examining room. Twenty minutes earlier, Ms. A had been laughing and cracking jokes while my attending physician and I obtained her medical history and life updates.
Our illness narrative, the COVID narrative, is about so much more than regaining health (though I acknowledge that for those afflicted by the disease, overcoming the debilitating circumstances may be more than can even be hoped for). Returning to Frank’s ideas, our narrative is about rediscovering the voice that was stolen by forces beyond our control.
This feeling of loss and subsequent reflection revealed to me something fundamental about how I experience time in my own life. As I depart the anatomy lab, I stand on the shores of time’s river and gaze into the clear water’s surface. In it, I see a reflection of growth and of internal transformation — a reflection not of who I was but of who I have become. I emerge not only learned in anatomy but also with insight into the impact that individuals can have on one another.
Another day passed as I approached the deadline of my latest assignment. Our professor asked students rotating in the ICU to reflect and write up a patient encounter that influenced them deeply.