A letter to my first patient

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It was only my first week in the hospital as a third-year medical student when we met. I entered your room early Tuesday morning. Only knowing your chief concern, I knocked on your door and entered the room. You didn’t complain when I awakened you. You didn’t complain when I asked many questions about a story you had already relayed multiple times to others. You didn’t complain when I conducted a thorough neurologic exam despite not feeling well. In a time when you felt most sick, scared, and helpless, you showed me patience and kindness.

After we were finished, I told you that I would check on you later and left the room. As I reported the details of your case to my attending physician, he was quite perplexed as I detailed an odd constellation of symptoms and an unusual physical exam. I described the pieces of your story, but we could not seem to make them all fit. Specific labs and imaging were ordered, hoping something would give us a better clue. Ignoring my previous plans to study after arriving home that day, I repeatedly refreshed your chart time and time again, desperate for any update.

I came to check on you the next morning. We didn’t have much time to talk before you were taken for your next round of testing. With a quiver in your voice, you confided in me that you were concerned it could be cancer. I held your hand as I told you that at that point, we were unsure what was causing your symptoms. Noticing your distress, I sat with you until transport arrived, gave you my extra hair tie to keep your hair off your neck, and helped you up onto the transport bed. I hoped we would find a way to get you back to your normal self as I watched them wheel you down the hallway.

As my colleagues and I sat around a table discussing cerebral amyloid angiopathy after morning rounds, your results came back. We had only known each other for a little over 24 hours, but I struggled to suppress my tears during the meeting after reading the imaging impression. While I previously hoped we could find a source of your illness, I instantly regretted that wish after reading “possible concern for brain metastasis.” My throat tightened as I nodded along in our discussion, inevitably failing to focus on the topic at hand.

After ordering work up imaging for possible malignancy, I held my breath until the scans came back. Thankfully, all were negative. A sigh of relief washed over me, followed by the returning question of what was really going on. I thought of the stories you told me about caring for your father, your friends, and your flourishing garden in your backyard — and how illness could take these pieces of you away in one fell swoop. I listened as you said that you just wanted your normal life back, a life defined by how you could shape your world, not by how medical illness could shape you.

Unfortunately, we could only find an answer for some of your symptoms. You remained optimistic though, determined to keep healing after being discharged. Your strength and kindness inspired me. As medical professionals, we are constantly seeking possible explanations for various ailments. But you taught me that in a world dedicated to constant searching, humanity can always be found — not between the pages of a textbook, but between a patient and medical student. Person to person. Heart to heart. I will always remember the lesson you taught me – to be humanistic even during the times we feel least human.

Lindsay Fleischer is a medical student.

Image credit: Shutterstock.com

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