Reflections on Family Medicine
Many patient encounters, often brief, have left me with a lasting impression. I reflect on these moments by capturing the dialogue, gestures or quiet observations that occur when caring for patients.
Many patient encounters, often brief, have left me with a lasting impression. I reflect on these moments by capturing the dialogue, gestures or quiet observations that occur when caring for patients.
His hands were shaking as they gently peeled open a tattered envelope. I leaned forward, attempting to understand what he was trying to show us, then gasped.
‘Write Rx’ is a narrative medicine column offering ‘prescriptions’ for narrative medicine exercises. Each column entry begins with an introduction to the theme of the entry, offers literary excerpts to expand on that theme and concludes with questions that invite students to explore a corresponding narrative medicine topic. The goal is to offer space for reflection for busy medical students, as well as foster medical students’ communication toolkit in the increasingly complex space of patient care. Topics include cultural fluency, illness cognitions and more.
Over the next few days, workup revealed she was experiencing paraneoplastic cerebellar degeneration, a manifestation of her occult cancer. In a matter of three days, a patient who had come in for seemingly benign constipation was told she had metastatic lung cancer.
When I was growing up, I used to love a particular series of video games called Trauma Center. In 2010, they released a version called Trauma Team where you got to play as various medical specialists, one of whom was simply considered a “Diagnostician.” Dr. Gabriel Cunningham’s “cases” were some of the most challenging because you were presented with an array of symptoms, imaging, and lab work and started ruling in or ruling out diagnoses until you got the right answer.
Every day, twenty times a day, I listen to breaths. “Take a deep breath in and out… good… and another…” Mostly clear breaths, sometimes crackly, sometimes wheezy. I place a hand on the person’s shoulder, subtly offering kindness and connection. I enjoy this time to take deep breaths myself.
Simply put, the humanities seek to capture the mosaic of human existence across the chasms of jubilation and despair, life and death, love and fear. The humanities are both disciplines of academic study and modes of expression.
In my high school years, I had an English teacher, Mr. Moon, who once remarked that his dream would be to “write a paper” about a certain book we were reading, and publish it somewhere. “Write a paper”? Was he kidding? In his free time, he was going to write?
Tears for the dead, tears for the living / who persist in this world that is so unforgiving
Today, I am determined to notice love. The sun comes up bright and full each morning to keep us warm.
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.