I met Rosa on my first rotation. My clinical year began with overnight shifts on the obstetrics and gynecology service at an affiliate hospital. My second night was halfway over when, at two in the morning, Minnie and I were summoned to the emergency department.
It can be difficult to fully appreciate the events that transpire on a busy transplant surgery service, and as a fledgling third year student on my first rotation, I’d often find myself in stimulus overload — like a five year old who stops to look at every flower on a walk with their parents.
The paratrooper shook as they descended upon him. / Prepared to interrogate him with hollow-point questions
As a medical student deeply interested in education, books, and writing, I try to read widely, and am always looking for reading material at the intersection of these interests. Thus when a friend of mine described Robert Coles as a gifted writer, one who placed great emphasis on the value of stories to the practicing clinician, he seemed like the perfect fit. I had previously read some of his shorter pieces, but my friend suggested I read The Call of Stories: Teaching and the Moral Imagination.
I first heard the click, click of her black stilettos / Her heels narrowed to a tiny point that seemed to pierce the ground. / I imagined the floor whimpering at every step she took / The faces of terrified tiles reflecting in glistening heels
I come from a family of repeaters. We repeat the questions that had unsatisfactory answers, the jokes that got particularly good receptions, the requests willfully ignored, but most of all, we repeat the stories.
His eyes are hidden beneath a pair of shades. I wish I could see them. A tweed cap, or as I like to think of it, a “grandfather” cap, covers his head. He leans his back against the chair with his hands resting on a cane.
As a medical student, I always carry naloxone in my backpack. Naloxone is the antidote for opioid overdoses, and is readily available at most pharmacies in Boston. My medical school, Boston University School of Medicine, is located near the epicenter of the opioid epidemic in Massachusetts.
I thought about you and your wife today — about how we were neighbors. A fleeting thought chipped away at some mental dam I had constructed, and the details of those months flooded my mind in vivid detail. It was like remembering every little element of a past night’s dream all at once after lunch. I remember meeting you for the first time. We were riding the elevators, and you were lost. You were hushed and panicked as you spoke into your phone: “I don’t know, I don’t know where she is, I just want her to be okay.” The phone was held up by your shoulder as you used your hands to balance on crutches.
Delirium is a bread-and-butter presentation. The differential writes itself — stroke, infection, intoxication, electrolyte imbalances, shock, organ failure. The intellectual exercise this invites was practically invented for medical students, even if the final diagnosis (dehydration secondary to gastroenteritis) and its treatment (fluids) were relatively mundane.
In the five years that have passed since I met the 14-year-old girl who opened my eyes to the terrible crime of sex trafficking in the United States, much has changed. We have made strides in state and federal legislation to protect survivors, national human trafficking prevention months have been declared, and victims are no longer treated as criminals.
There was an elderly man suffering from late-stage Parkinson’s dementia. There was a patient with schizophrenia experiencing a COPD exacerbation. Then, there was Mrs. G, who was admitted for immune thrombocytopenia. She was a retired teacher who spent her time volunteering at her church and caring for family members.
Contributing Writer
Columbia University College of Physicians and Surgeons
Joshua Stein is currently a Class of 2018 medical student at Columbia University in the city of New York. He graduated from Washington University in St. Louis with a bachelor's degree in neuroscience and subsequently earned a Master of Science in Teaching at Pace University. Prior to enrolling in medical school, he taught science for two years in the New York City public school system.
