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Jell-O, Phone Calls and Other Small Stuff

As I reflect on my year of clinical rotations as a medical student, my mind instantly conjures up some of the biggest moments I’ve experienced.

There have been euphoric highs, like delivering a beautiful baby girl to first-time parents on Mother’s Day. And heartbreaking lows, like having a panic attack in the bathroom after a patient with psychosis shared his delusions about race with me.

On days with big moments like this, I feel as if I’m playing a role that I’m wholly unprepared for: being present for patients’ life-altering moments, assisting in surgeries that change a person’s anatomy forever and listening to stories that have never before been told.

On these days, without fail, I call my mom or my partner on my walk home. During these calls, I debrief and open up about the spectrum of human experience I’m witnessing. Those patients stay in my thoughts for a long time.

But one of the things I‘ve struggled with this year is that sometimes a patient doesn’t have big moments. Sometimes the day passes and I wonder whether we did anything to help them. Sometimes their health is deteriorating microscopically day by day, and one visit to the hospital will not change the trajectory of their life. Sometimes their physical health rests precariously on a crumbling foundation of poverty, abuse, isolation and heartache that we cannot treat.

At the start of the year, I found these patients very frustrating. When I rotated on an internal-medicine service, I grew jaded very quickly. I noticed how often some patients bounced back into the hospital or failed to follow up with appointments or fell back into their previous patterns of substance use. In an attempt to avoid feeling attached, I spent less time in patients’ rooms—and the days began to feel monotonous, empty and gray. As a medical student, I felt helpless, not knowing what role I could play in such a tangled web. I worried that we weren’t doing enough for these patients, or that the system was so broken that we couldn’t help even if we tried.

But in time, it was with these very patients that I began to feel most helpful. One of my patients was incarcerated, completely disabled and very lonely; I sat at his bedside and listened for an hour as he told me about his youth working on a farm in Tennessee. Emaciated and immobile, he shared stories of derring-do—rescuing cattle from deep mud and manipulating dangerous machinery.

One night shift at 4:30 am, I spooned cherry Jell-O into the mouth of a brand-new mama drenched in sweat (and a little loopy on pain meds) while she had a vaginal laceration repaired.

Every day for two weeks, I talked on the phone with a woman whose nineteen-year-old son had been hospitalized for first-break psychosis, updating her on how I was seeing more and more of her son’s old self peek through the illness.

For one gentleman, I sat on hold with the hospital’s IT department, waiting to set up the patient portal on his phone so he could find out the results of his HIV test.

I befriended a nurse and helped her move a patient to the commode and back every two hours; during these trips, the patient told me the meanings of her children’s names and confided her aspirations to be a better mother after the hospitalization ended.

Reflecting on these experiences, I was reminded of what my own mom often told me and my five siblings growing up.

“Don’t poison the soup,” she’d say. “Each of us is a different ingredient in the soup; we can make it tasty, but we can also spoil the whole batch with a bad attitude or a harsh word.”

I realized that the same principle applies in the hospital. We each start the day with a choice and the chance to bring joy to those whom we encounter.

Coming into medicine, I thought that being a doctor was about being there for the big moments, when everything is chaotic, lives are on the line and your hands are there to save someone. But the reality is that we are also our patients’ caregivers through all the little moments, the small acts of service—the trips to the nutrition room for graham crackers, the phone calls and faxes and all the super-unglamorous stuff.

Now I no longer feel frustrated by a day that’s made up of small moments. Yes, I still get angry at a healthcare system that seems, at times, like it’s setting everyone up to fail—patients and providers alike. But I’ve learned that I can play a role in making every day count.

On those days, I don’t call anyone on my walk home. I take the scenic way through the trees, listening to music, thinking about how privileged I am to be in the hospital—to be a tiny part of making someone more comfortable or more safe or more heard. I realize now that I’d been naïve to think that hospitalization would not alter the trajectory of my patients’ lives. Because it can. And sometimes, as I’ve learned, it’s just about altering the course of someone’s day.

I hope never to be a doctor who’s too busy to pour a Sprite for a patient or to grab an extra blanket for them. I know that one day I’ll be a resident, and then an attending physician. When that time comes, I’ll be a part of the bigger moments more often. But I don’t want to lose sight of how important these “small” moments can be, and how great an impact they may have on the people I care for.

I want to hold on to this feeling.

Rosie Mahoney, a third-year medical student at Vanderbilt University School of Medicine in Nashville, hopes to pursue a career in obstetrics and gynecology. She grew up in Great Falls, VA, and studied neuroscience and linguistics at Dartmouth College. “In addition to women’s health, I am passionate about medical education and health equity and hope to pursue a career that includes all three. I use writing as a tool to capture special moments that may otherwise be forgotten, and the emotions I felt at the time.”

Comments

9 thoughts on “Jell-O, Phone Calls and Other Small Stuff”

  1. Swarnalatha Meyyazhagan

    Beautiful ❤️ Well said
    Though everyone of us have definitely enjoyed these moments, you have poured it out eloquently on all our behalf.
    “Writing is the painting of your mind”.
    Please keep doing all you are dreaming, for life.

  2. As another 40 plus year Family Physician I can’t help but think back to our initial charge as physicians: heal when possible but always provide comfort.
    With so much technologic emphasis on diagnosis and healing options today it is difficult at times to remember our obligation to comfort. Rosie, please keep comforting your patients. Those “little things ” are huge. When you’ve got forty plus years under your belt it will be the “little things” you will remember…and that your patients will remember. Thanks for your brilliant essay.

  3. Margaret Falkovic

    Do your little bit of good where you are; it’s those little bits of good put together that overwhelm the world.

    Desmond Tutu

    1. How you spend you days is how you will spend your life. I have been on both sides of a warm blanket -giving it always will let the patient know you see them and care and when I was ill I remember that honking the blanket was the physical representation of the clinician’s warmth and kindness. Enjoy your days it will go so quickly

  4. As someone who practiced IM for ten years I can assure you those seemingly small actions do make a big difference. The system can be overwhelming to navigate for patients and clinicians alike. The personal touch helps. Make sure to respect your boundaries and take care of yourself so that you may have a long and satisfying career. Good luck to you!

  5. One of the most moving stories I have read on Pulse.
    .
    As you move along in medicine, try not to lose sight of the
    Importance of those “little moments.”
    But somehow, I don’t think you will.
    You understand the importance of patient-centered
    medicine.

  6. I hope you never lose the determination to do little things for patients. As a family doctor with 40 years experience, I found that sometimes that had more to do with healing than the medicines I gave them.

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