While on my inpatient psychiatry rotation, I had the opportunity to work with an adolescent female with a troubled past and a significant history of psychiatric illness. It was through coloring that her barriers broke down and we were able to establish a safe space for difficult conversations. She was safely discharged two weeks after her suicide attempt. As she left, she gave me a hug and handed me this:
At the top of the page it said, “Always remember me.”
Third year medical students have no base, no one hospital or one discipline within medicine to call home. In many ways, we have no defining identity — as a first or second year, you are a “student” and as a fourth year, you begin to proudly identify with a field and boast, “I’m going to be a radiologist, surgeon, etc.”
We are vagrants, shifting to and from different services, different rotations, different hospitals, different cities; the fortunate byproduct of this circumstance is that we literally have encountered hundreds of patients across various fields and walks of life in just six months of training. This got me thinking … can we ever really remember all of our patients?
Third year of medical school provides us with the unique opportunity to finally put a face to a textbook page. It is incredible how much you retain when you learn about failure to thrive and hypertension from patients and not books. The reason why this kind of learning is so effective is because we are able to link a narrative, experience, and personal memory to a medical term. The synapses are strengthened as the medical term becomes entangled and entrenched in the midst of this messy but purposeful web. Their stories, their wounds, their tears, their triumphs, and their presentations are all intricately woven into the fabric that envelops our training. We may not remember specific names or faces, but we remember complications, we remember suffering, we remember that joke you made that one morning, we remember lab values to look out for, we remember medicine and we remember humanity through each patient.
As we negotiate through the trials and tribulations of medicine this year, we realize that the only thing that binds us is the common experience of collecting a database of patient memories from which we draw upon. It is from them that our identity within medicine can develop. Through our patients, we find ourselves. Those memories not only shape the decision of what kind of medicine we choose to practice, but also, what kind of physicians we choose to become. As we go on to treat the next patient that comes along with hypertension, we use the memory of our prior patients to guide us. And so the answer to my question is yes. We really do remember all our patients, in some way, all day, every day.
I was truly touched by my patient’s sentiment. I think deep down we both knew that twenty years from now, I may not even remember her name or maybe even what she looked like, but I will always remember the feeling of the first time I saw her smile after coming to terms with her years of suffering. There was nothing left to say to her but “I always will.”
Trisha Kadakia is a medical student.