It was his first visit to a hospital–any hospital–since his birth in this one eighty years earlier, and the trip to the emergency department for blood in the urine soon escalated into a workup for bladder cancer. He became one of the most memorable patients of my medical school experience and, for that matter, my entire career.
Though so crotchety that some of the staff avoided him whenever possible, he and I always got along well. I listened as he told stories of his ten children and how he could not stand any of them, and I laughed as he playfully teased his wife of sixty years and told tall-tales of losing his left testicle. (Which, by the way, were proven false on physical exam!)
Soon, things changed.
The CT scan showed a mass. Given his presentation and history, bladder cancer appeared likely. He would need a cystoscopy to remove the tumor and confirm the diagnosis. My patient was worried, and he refused the procedure. I noted his hesitancy, and drew a basic diagram to help explain the cystoscopy. He seemed at-ease after looking at the sketch, and was more than a bit amused by my rendition of a scope ascending the penis to extract a bladder mass.
That drawing did not seem like much to me, but my patient brought up it up every day after that. He made sure to tell my attending about the sketch and how it had helped him understand his procedure, which he later agreed to and tolerated well.
As he neared discharge, we discussed another cystoscopy that he would need as an outpatient, and he told me he was not at all worried because I had explained the last one so well. I felt proud when he said that, but not as proud as I did during his last day on our service, when he asked my attending if he could have a follow-up appointment with “the young doctor” who had been so helpful during his stay. It took a moment for me to realize that he was talking about me.
While other patients had mistaken me for “a” doctor during my time in medical school, he was the first to ever view me as “my” doctor in that special way, as he grappled with a diagnosis that would change his life forever. I will never forget that.
Alex Nusbickel
Gainesville, Florida
