Losing that patient was one of my most traumatic experiences


The cadaver lab is a rite of passage in medical school — those few months early on when we dissect a human body to better understand our anatomy. It’s grotesque: peeling back skin, separating muscle sinews, and sawing through bone.

It’s so emotionally jarring that young doctors in training often compartmentalize the experience, and this person before us becomes organs and bones we deconstruct in the pursuit of knowledge. We never learned our cadavers’ names. We never met their families. We knew nothing about them, other than they donated their bodies to our education.

So we made it up — entire lives, on the hint of a scar, or the color of nail polish, all so that the body before us stayed human. It was an act of empathy, a complicated one because it also ended up helping me cope with the trauma of dissecting a human body. But afterward, I wondered, in imagining the details of these lives, do we end up dehumanizing the people we are tasked to care for?

Earlier this year, I had a patient who died. He was homeless and suffered from chronic mental illness. Once again, I found myself standing over a lifeless human body.

As far as I knew, my patient was alone, and his illness made it impossible for him to clearly communicate his needs. His death was shocking and violent, as efforts to resuscitate someone often are. I was scrambling to find meaning in the fact that he was suddenly gone forever.

“Can we just take a moment for this man?” I asked my colleagues. “He has no one.”

As I had done in medical school, I created a story — I thought my patient was invisible, and maybe, unloved. That story ended up being as far from the truth as is possible, and his reality was far more heartbreaking than I could have imagined in that moment.

Through some miracle of social work, we were able to track down his family, and they rushed to the hospital to be with the son and the brother they had lost long ago to mental illness. As my patient had detached from his family, they had never stopped looking for him. His elderly father used to drive around and wait outside shelters for a glimpse of his son, to know that for a minute, he was alive.

They never stopped loving him. He wasn’t alone. He was cared for in the only way his family could.

Losing that patient was one of the most traumatic experiences of my budding career. But the way I chose to cope — creating a story for him, asking my colleagues to remember him as I thought he was — has made me realize that I might have been well-meaning, but my act of compassion served no one but me.

There’s an animated film called “Kubo and the Two Strings,” about a boy who must learn about his family and his past to defeat a villain. In that defeat, the villain loses his memory, and rather than remind him of the evil and sadness he had wrought, Kubo fills his head with fake memories of happy deeds.

I hated it.

“We need to remember all the bad things, so we don’t risk reliving our mistakes,” I told my husband. “We can’t just rewrite people’s stories when it’s expedient.”

But, of course, that is exactly what I had done. It was easier, or more expedient, for me to suffer the loss of a dreamed-up nobody, rather than the loss of a real somebody.

As my patient’s mother sobbed on my shoulder, my arms around her, I silently asked for her forgiveness for minimizing her son’s life — and doubting her unconditional love for him. With this experience, I’ve recognized that empathy also means being able to imagine all my patients’ possibilities, even the ones that are hard to stomach.

“I don’t understand this disease,” his mother cried. “He had so many places to live.”

Jennifer Adaeze Okwerekwu is a psychiatry resident and can be reached on Twitter @JenniferAdaeze.  She writes the Off the Charts column in STAT News, where this article originally appeared.

Image credit: Shutterstock.com

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