The hardest thing to do as a physician

I’ve been told that one of the hardest things that a physician endures is the passing of her first patient. However, what I imagine to be even more challenging than this is pronouncing the death to the patient’s family for the first time. Although I find myself in a similarly intimidating and burdensome position of addressing the loved ones of our gracious donors tonight, for my first time, I feel great relief that I do not have to experience either of those things I just described. Instead, I have the rare privilege of delivering news that I hope will make loved ones feel proud, even in the wake of loss, by recognizing the transcendent gifts passed on to us by our donors. These are the gifts of trust, knowledge, and life.

It has now become apparent to me that irrespective of life or death, there is nothing more sacred than trust. For the physician, trust is what sustains the patient-physician relationship. For us students in training, trust is what lays the foundation. From the first moments when we were introduced to our last, our donors offered us unconditional belief in our abilities, premature as they may me. This is something we have not taken for granted for it was experience of this first deep connection that taught us to care for others. Even with death at the interface of our interactions, it did not hinder our ability to protect and serve and our donors’ ability to endlessly provide. Receipt of such steadfast confidence has been especially important because we now carry this as the benchmark for the rapport to achieve with patients, whom we will also serve, in the nascent future.

For me, the trust also played, and continues to play, a quintessential role in filling the gaps in trust I had of my own abilities as an aspiring doctor. As I have come to quickly learn, medicine is a field replete with complications and imperfections. Even the science taught in the classroom, which we use to guide praxis, at times appears to be incongruent with the reality we witness. These are conditions which cast great doubt over the early students of medicine. Nevertheless, the donors tolerated my mistakes and lapses in understanding. They pushed me to be assertive when I was timid and methodological when I was stubborn. They conveyed to me that it was OK to feel frustrated, so long as I coupled that with newfound optimism. And it was through all of this they showed me that trust is something to be shared, not something that is singly received or given.

Needless to say, no field would exist without knowledge. In the case of medicine, which I consider to be the marriage of the sciences and the humanities, this rings ever more true. While study of human anatomy entails the meticulous surveying of structure and function, this is meaningless without seeing and knowing the host to whom the biology belongs. It would be like singing to a song with no melody or writing a story with no purpose. Or put another way, in the more relatable words of the late Dr. Osler, “the good physician treats the disease; the great physician treats the patient with the disease.” Our donors provided us with knowledge that can neither be captured by the lectures of our most erudite professors nor absorbed from reading the most sentimentally-charged books. With each encounter, they showed us how to contextualize disease within the depths of human emotions and how to appreciate the individuality of each patient we will soon encounter. And through this process, we also learned to humanize ourselves so that we do not grow desensitized to human connection. So, this gift of knowledge to us is also a gift to all those we will humbly serve as physicians.

A close friend once wrote to me that through her direct encounters with human fatality, it became easier to appreciate the true fragility of life. I’m sure this was meant to describe how vulnerable we are to disease and how easily we can also succumb to the grip of death. All of this is very true. However, this has not been my gleaning from my relationship with our passed donors. In fact, if there something I have come to better understand about the relationality of death to life, it is that the line which demarcates one from the other is actually not so easily discernable. This is evident at a memorial like tonight, where it is palpably clear that our donors continue to show their presence by allowing some to reflect and reminisce over memories past and others, like myself and my classmates, to imagine and long for the future of serving that lies ahead. So, death is not merely a symbol for human frailty and mortality; death, even in the most vulnerable form that we encountered, is a celebration of the resilience of life — a lesson I will take with me to the end.

Despite the feelings of deep gratitude I have shared tonight, I still feel the great weight of loss and despair. Although I have done my best to put into words my thanks to the donors, I know I will always fall short. Therefore, I will extend my thanks to the esteemed guests of our donors — without whom none of this would even be possible — by vowing, on behalf of my class, that we will show our deep appreciation through the selfless lives we will lead. Unlike the hardship involved with announcing the death of a patient, I find making this sort of declaration far easier. Thank you very much for your gifts.

Kitae Chang is a medical student.

Image credit: Shutterstock.com

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