I am just a medical student

She’s 58, but appears maybe three days older than 42. Her eyes are sunken, tearful, worried, anxious.  She tells me about her two grandchildren, and how she just visited them in Michigan.  She came to the hospital, straight from the airport.  She’s worried.

She’s worried because her shortness of breath hasn’t gone away for over a month now.  She has had breast cancer, and opted for a more conservative approach: a lumpectomy with axillary node biopsy without radiation.  She’s admitted, and gets a chest x-ray and a CT scan, which show a pleural effusion with what looks like nodules in both lungs.  “Likely represents metastatic disease,” reads the official radiology report. She knows, so I don’t bring it up again.

“I am just a medical student,” I think.

On the second day, she undergoes surgery to evacuate the effusion, and her lung is biopsied.  Now, we wait for the pathology report.  I visit her every day as we wait, sometimes two or three times. I’ve met her husband, and we know each other by first names.  Her daughter and son are also beautiful people, just like her.  They ask me questions, and I keep my answers limited to what I’ve read in the chart. They never ask me about the cancer. They know what the radiology report said, so I don’t bring it up again.

“I am just a medical student,” I think.

She never complains. Not from post-operative pain, not from shortness of breath, not from coughing, not from anything.  I take my time with my physical exam, ensuring that I don’t miss any tenderness.  I don’t want her to suffer unnecessarily.  “Surgery is painful,” I tell her, “make sure you let us know if you are in pain.”  She agrees, but never complains.

The nurse corners me one afternoon, and asks me, “Is there any way to put in an order for morphine PRN for her?”

“I am just a medical student,” I think.

“Why?” I ask.

“Because when her family isn’t here, when she’s alone, she cries.  She’s in pain, she’s scared, but she’s a silent sufferer.”

I am the first person she sees every morning, and I try to make sure she’s comfortable.  I offer extra blankets, water, anything I can do just to make sure she is as happy as she can be.  She appears more and more cheerful, and I spend what seems like hours holding her hand and chatting about life, the weather, her family, my family, my future goals, my girlfriend.  I show her pictures.  We laugh. We smile. But her eyes remain anxious and worried.

She says she likes my bowties, so I make sure to wear one every day for her.  And I tell her, “I thought of you when I put this one on this morning.”  She smiles through those tearful, anxious, worried eyes.  I smile back. And that is enough to make my day.

I walk in with my bowtie and smile around 6:30 p.m. She just got back from the CT scanner, and her family is around her bed, as per usual.  I visited, just to say goodbye for the day.  The sun dips a few degrees further west, just enough to peak through the curtains, and her husband turns to me and says, “Edwin, thanks for bringing the sunshine.”

I stand there, in a loss for words, armed with little more than a bowtie and a smile.

“I am just a medical student,” I think.

Edwin Acevedo, Jr. is a medical student.

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  • Brettwurst

    Very nicely written, Edwin. Keep doing what you’re doing.

  • Dee Coyle Tocci

    And hopefully, you will always be a medical student. Never lose that humility and you will be one fantastic physician!

  • Peggy Zuckerman

    As a patient, I wonder if you overestimate the amount of information which the patient and/or her family have available to them. She may or may not have read the radiology report, nor understood the implication of that report. Moreover, she may not have permitted her family to read the report, and if they were to ask for it, HIPAA regulations may have prevented the family from access.

    My concern is that there seems a lack of communication to the patient, nor a method for assessing what the patient knows–or what her rights are while under care. By the description of the patient, she is trying to protect her family, which may be at the expense of her health. There may be missed opportunities for both the patient, family and the medical student, and all that he can offer.

  • Coleen Gosnell Wheeler

    Beautifully written. Thank you for being you and for sharing!