The hospital unit was silent other than the occasional beeping of the telemetry monitors. The nighttime staff’s chatter grew fainter with each hour. The evening had set in hours ago. I had completed all of my assignments except for one: a patient I had yet to see — a teenage girl with a severe skin condition who was also suffering from depression.
“Come in,” a gentle voice called out before I could finish knocking. She ended a conversation on her phone as soon as I came in. I introduced myself and apologized for interrupting her call. She reassured me not to worry as she spoke to that person often. This relieved me.
I knew she was in a difficult legal situation that was taking an emotional toll on her. After learning that she had few visitors, I asked about her depression and how she was coping. As she spoke, I could not help but think about the degree to which her social isolation was worsening her symptoms.
Looking around the room, there was no doubt that she had been living in the hospital for far too long. Piles of worn clothes and used notebooks were scattered across the room. However, hidden underneath the clothes were several instruments. Her face beamed as soon as I asked her about her musical hobbies. Soon enough, we were chatting about her songwriting aspirations, school and her career goals.
Throughout our conversation, she giggled and tucked her hair behind her ears. She remained poised even as she spoke of the challenges she faced. So many systems had failed her, leaving her with no stable home or support network. As our conversation came to an end, I reminded her of how strong and smart she was. She glanced down, hiding her soft grin.
Driving home that night, I felt crushed by all the issues she carried on her shoulders at such a young age. The interwoven nature of her problems was evident as her skin disease and social circumstances took a toll on her mental health. Her skin disease, psychiatric disorder, legal situation and insufficient social support all added layers to the complexity of her case.
There are so many aspects of our patients’ lives that we, understandably, barely address due to time constraints or workload. While I recognize that physicians cannot solve all their patients’ problems, I hope to continue to see my patients’ problems for what they truly are: not just a sum of diseases to manage, but rather fluid components that influence each other and ultimately a patient’s health and well-being. My patient taught me so much more about her health than I would have learned by only reading her chart. In one brief moment that night, she taught me the meaning of treating the patient as a whole, not just the disease.