On a beautiful spring morning, I found myself in an outpatient OB clinic, ready to begin the last rotation of my third year of medical school. My attending physician greeted me and patiently (but quickly) showed me the ropes. I spent the better part of the day using a doppler to detect fetal heart sounds, measuring fundal heights, reading ultrasounds, and learning how to do pelvic exams on my incredibly gracious patients.
The sights and sounds of OB were unlikely anything I had seen on my other clinical rotations. Yet, when my attending physician exclaimed, “Isn’t OB amazing?!” I had to force myself to muster a smile and nod in agreement. I really was enjoying myself in clinic. And I really did connect with my female patients. But at this point of the year, I was aware of the challenges that accompanied a clinical rotation of medical school. I knew that I was being evaluated. I knew I needed to go home and study for a multiple-choice test. I knew that as soon as I felt like I was getting the hang of OB, I would have to leave for a different rotation. I did like OB — but I was tired.
As we neared the end of the day, my attending physician glanced at his schedule with a puzzled expression. “Let’s see this next patient together,” he said, “according to this note, she’s almost completely paralyzed.”
We entered the room to find a young woman, YW, in a stretcher accompanied by her husband and several caregivers. She had almost no motor function. And, as far as we could tell, communicated only through eye movement and somewhat indiscernible vocalization. It was unclear to us how much of our conversation she was able to understand.
After greeting YW, my attending physician turned to her husband, HH, and began to elucidate the history. We learned that YW had been in a seemingly perfect state of health. Then just a year earlier, she had suffered the spontaneous rupture of a previously asymptomatic brain aneurysm. She was left with an almost complete lack of motor function. Her cognitive function was unclear due to her inability to communicate. The damage was likely irreversible.
As HH told us about YW’s history, he stood by her side, lightly stroking her hair and holding her hand gently, whispering to her when she cried.
My attending physician and I conveyed our sympathy and asked him to tell us about her. Both of our eyes brimmed with tears as he recounted the moment he had fallen in love with her years earlier. As he told us stories of the brief but blissful years, she spent as the young mother of three beautiful children, as he painted an image of her affectionate and vivacious spirit.
All the while, there was no sentiment of pity in HH’s voice. He told us about the challenges he had faced in coping with his drastically altered reality and in raising his children without YW’s support. While he described missing his wife, he never once complained about having to care for her. When my attending remarked, “It must be so difficult for you to be a caregiver,” he simply responded, “Of course it is — but my love for her makes it worth it.”
In medical school, we are taught about resilience. We are told that our professional success is dependent on our ability to move past obstacles and to adapt to extenuating circumstances. But all I could think about as I listened to HH was how egocentric the last year of my medical education had felt. I entered medical school with the desire to care for my patients with love and understanding. But during my clinical rotations, I was forced to spend much of my time focusing on my own education in order to hone my clinical skills.
As medical students, we are forced to think about our plans for residency and to plan for the “next step” in our professional trajectories. As a result, the thrill of entering the wards and finally learning how to take care of patients is accompanied by the looming pressure to succeed. The more I fed this pressure, the less connected I felt to my profession.
HH’s resilience moved me, as it was rooted in deep, selfless, and unconditional love. While the physical and emotional demands of medical training force us to become adaptable and tenacious, I believe that our resilience is derived from the drive to help others that brought most of us to medicine in the first place. Self-reflection and self-improvement are critical aspects of clinical practice but maintaining our desire to care for our patients is vital to building our professional character.
HH reminded me that the treasured moments I spend at the patient’s bedside are integral to the foundation of my clinical career and that as much as we are taught to build character, we have the most to learn from the patients and families we meet every day. As Hippocrates famously stated, “Where the art of medicine is loved, there is a love of Humanity.” I would add that where there is a love of Humanity, there is true resilience.
Prerana Chatty is a medical student.
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