Details in this piece have been changed to protect patient privacy.
The first thing I noticed entering Betty’s room was her walls.
They were papered, nearly from floor to ceiling, with photographs of celebrities. Taylor Swift, Sam Smith and Ed Sheeran all stared back at me. However, the prevalence of Shawn Mendes far outnumbered the others with dozens of his pictures present. I pulled my eyes away from the photographs, forcing myself to focus. Glancing around the room, I made eye contact with my new patient’s one-to-one, a provider assigned to give constant supervision, sitting in a plastic armchair in the corner of the room. She smiled at me then looked down, as if trying to be unintrusive. I took this as my cue to speak.
Betty sat on her bed, her head bowed. She rocked slightly back and forth, running the palms of her hands up and down her legs. It did not seem like she had noticed me yet. I took this opportunity to run through silently what I had gleaned about her from her chart.
22 years old.
Admitted involuntarily for 90 days for suicidal ideation.
Three previous suicide attempts.
I introduced myself, then explained my role on the team. Betty nodded a few times, her brown curls bouncing with the movement. She continued to sway, sometimes slapping the palm of her hand against her chest. I went through the script I had rehearsed before coming in: asking how she had slept overnight, if she was eating and if her medications were bothering her. Betty gave me short answers in response, grabbing a pillow from her bed and hugging it to her chest.
She looked tired — large dark circles beneath her eyes. Occasionally, she would glance furtively at the corner of the room, narrowing her eyes in anger. I fought the urge to turn my head toward whatever she was looking at. Mostly, I took in how young she was. Three whole years younger than me, here, with only her one-to-one and some photographs to keep her company.
I would not be super chatty about whether I felt nauseous or if my medications made me dizzy, either.
Stepping forward, I closed my folder with the notes I had scribbled in it and unclicked my pen. Betty stared back at me, meeting my eyes for the first time. Her eyes, though a rich brown, were dull.
“Do you like Shawn Mendes?” I asked, gesturing to the walls.
Slowly, like the sun creeping over the horizon, her face filled with wonder.
Over the three weeks I spent on the inpatient psychiatric unit, I would get to know Betty very well. I learned that she loved soft pretzels, that the scent of eucalyptus and spearmint hand lotion soothed her when she was anxious and that she hated being five hours away from her family. I learned her story, listening to her pick-apart traumas from her childhood that haunted her, even now.
At this point in my medical education, I had only experienced a seven-week surgical rotation, where my patient continuity was almost non-existent. Here, I had the luxury of being a third-year student with far more time on my hands than anyone else on the unit. I learned how a patient-provider relationship can work its way into your heart and take root. Betty was the first patient I got to know in a meaningful way, the first patient I truly talked to. And talk we did.
“Of course I am Team Edward!”
“I printed out this new picture for you to color in today, it is a sea turtle.”
“Are you leaving for the weekend?”
“Do you think I will be able to go home soon?”
As the days passed, I began to dread the end of my psychiatry rotation. Not because I saw a future for myself in the field, but because I knew the inevitable goodbye was coming. We had played jump rope with the line between provider and friend, and now, I would have to go. She would have to stay.
On my second to last day, I found Betty sitting outside in the courtyard.
She leaned against the wall, her face tilted up to the sunshine. Her one-to-one, a different woman this time, sat on her right. Chalk drawings of butterflies, flowers and a rainbow decorated the pavement in front of them.
I walked across the courtyard slowly, my feet and heart heavy. Betty gave me a wave, her face splitting into a wide grin. I reached them, leaning against the wall and then sliding down until I sat on Betty’s left. Our legs stretched out in front of us, my sensible black pumps a stark contrast to Betty’s bright sneakers. We chatted for a few moments, until finally, I cleared my throat, getting ready to broach what I knew would be a tough topic.
She listened quietly as I explained how medical students rotate through different areas of the hospital. That my time on this unit ends tomorrow. That next week, there would be new medical students for her to get to know. Once I had finished speaking, she did not look at me, instead glancing down at her chalk-covered hands. Finally, she replied,
“Every time I get used to someone, they leave.”
And so, I swallowed one of medicine’s most bitter pills: that, sometimes, you just never see a patient again. The continuity I had enjoyed, craved, was ripped away from me, and I had so many lingering questions. Did Betty ever find a medication regimen that worked for her? Did she get transferred to that different hospital for ECT? Did that sweet soul find a soft place to land? Will she ever get to see a Shawn Mendes concert?
I will always wonder.
WiTTY Wednesdays is an initiative showcasing the works of our Writers-in-Training Program writing interns. WiT is a year-long internship for budding medical student writers. Our interns receive intensive, one-on-one mentoring from our medical student program directors and publish at least 3 pieces during the course of their internship. If you are interested in learning more about the program, please contact us at firstname.lastname@example.org.