A 5-year-old African American boy presents to the emergency department with left leg pain. His leg is exquisitely tender to palpation…. If I read this vignette in the first year of medical school, I would have navigated to the multiple-choice answers to select anything related to sickle cell disease. The question writers are stating that the patient is Black, young and has a painful limb — this is not a difficult diagnosis. Rather than envisioning …
A seedling, a baby — / the most vulnerable state. / Roots, placenta ground into mother — / wholly dependent on a magnificent caretaker.
The first thing I notice are his boots. He’s still in his street clothes, having just been admitted. He looks thin, emaciated — his clothes hang off him, shirt collar drooping down from his neck like peeling paint. His boots, however, seem to fit him properly. They look warm, well-worn but sturdy, like they have weathered a hundred bitter winters and could withstand a hundred more. For some reason, this comforts me.
Upon arriving at the room, we learn that the nurse continued trying to speak to this patient in English despite the patient’s evident inability to speak the language. Following her half-hearted attempt at “patient education,” she proceeded to lift the patient’s gown and attempts to strap on the monitors. As a result, the woman is frightened by her nurse because she is unaware of what this foreign nurse is doing to her and her unborn child. One week out from detention. She is scared. Imagine.
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.
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.
When I was 17, I went to the gynecologist for a Pap smear because my mom said, “Once you have sex you have to get one.” It felt like punishment, but it was also the only way I had a chance of getting birth control. I went to three different doctors and exam after exam, they kept saying I could have cancer. I did a ‘colpo’ — whatever that is. After that, they did three different procedures on me, three, all to take pieces of my cervix. I don’t remember what they were called or what even happened. All I remember is the pain.
I entered the office of the Community Health Council of Wyandotte County, Kansas City, on a muggy, late-summer day during my family medicine rotation. The air-conditioned building boasted a large front room with sporadically placed desks, children’s books and toys, and what looked like a large food pantry. I flexed my elbows and wagged my arms to fan out the sweat from my Black body enshrouded in my white coat.
I had developed a strong friendship with Ms. D during the rotation, and her passing became one of the first confrontations with grief that I encountered as a rising medical student.
Thank you for your contributions and your readership over the past year. It has certainly been a difficult one, and we are exceedingly grateful that you all used in-Training as a platform to share your reflections, opinions, and solutions. Run by medical students and for medical students, your ongoing support is what makes us a premier online peer-reviewed publication. We look forward to seeing your contributions in 2021, and we’re excited to see where the year takes us (hopefully some place better!).
My first day in the morgue was a shock to the system — the smell of death, the sight of rigor mortis and the comfort of everyone around me with the task at hand. I thought my prior health care experience prepared me for this, but it clearly did not.
5:00 am, the first day on the night shift, / six deliveries completed and only one hour remains. / A call from the nurse says the patient in 14 is five centimeters dilated, / and so we enter the room to rupture her membranes.