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Disposable

As a third-year medical student, I was two weeks into my trauma-surgery rotation when my resident casually called me “disposable.” I wasn’t offended—in fact, the word perfectly described how I’d been feeling. I also understood that it was no reflection on my performance; rather, it was a commentary on medical students in general.

Surgery was the first rotation of my third year—and, now that the COVID pandemic was winding down, it was also my first in-person clinical rotation.

I’d never been on the floors of the hospital. I felt clueless, underprepared and incompetent. I constantly got lost running around the hospital floors. The highlights of my surgery rotation so far had included never getting my fingers into the right holes of the surgical gloves, accidentally following residents into the bathroom and mistakenly clapping at a morbidity-and-mortality meeting.

As a member of the trauma team, I’d quickly learned that my job was to stay out of the way, especially during the most critical emergencies. Occasionally I’d fetch a warm blanket for a patient, and one time I even got to use the trauma shears to cut off a patient’s clothing. During surgeries, I felt completely superfluous. After one scrub technician had taught me how to scrub in, a different scrub tech yelled at me for breaking sterility before I’d even taken the first step in washing my hands.

I felt keenly aware that I was more of a burden than a help—and I had no reason to believe that my other rotations would go differently. Not until my internal-medicine rotation, two months later, did I realize that this might not be true. 

I was assigned to the geriatrics/palliative-care team—my first experience with this kind of care. The first day, the attending told me to go down to the emergency department, do a complete history and physical on a patient named Mr. Knight, then present this information during rounds.

Seeing the look on my face, the attending paused.

“Just go see the patient,” he said calmly.

After quieting my heart rate and glancing at the patient’s chart, I went down to the crowded ED and found Mr. Knight on a gurney in a hallway.

I introduced myself and asked, “What brings you to the hospital today?”

His answer was mostly gestures and faltering utterances: “I…I…fell…my…s-s-s-on’s house…trying to…clean.”

I felt a little uncomfortable, because he was having such trouble communicating, and I couldn’t immediately assess his cognitive status. The lack of privacy didn’t help: I grabbed a mobile curtain and pulled it to encircle us.

Thinking back to Mr. Knight’s chart, I remembered that he was a stroke victim with aphasia. Rounds wouldn’t start for an hour, so I sat with him while he told me his story.

It soon became apparent that he was mentally intact—and, to my relief, that he had a good sense of humor. He also wanted to know more about me.

“What do you like to do?” he asked. “How many more years of school do you have left?” He made jokes about his fall and asked me for the hospital wifi password so that he could place his sports bets. 

At one point, he stopped in midsentence, then said, “I’m sorry, I find it hard to multitask.”

He clearly found his aphasia frustrating, but I waited, not interrupting, while he struggled to find words. For my part, I felt grateful that he wasn’t annoyed at me for asking the same questions that patients get asked repeatedly—questions that seem to have nothing to do with their chief complaint.

“I’ll be back later today with the rest of my team,” I said, getting ready to leave. “I’ll present your case to them.”

When our team walked into Mr. Knight’s room, he looked past the doctors and residents and right at me. “Bobbi!” he exclaimed, to my shock. In this academic hospital, I’d noticed, the patients saw so many doctors, nurses and students that they either couldn’t remember people’s names or gave up trying. It felt really nice that Mr. Knight remembered me—as if our time together had made a difference to him.

This feeling sustained me through the nerve-wracking process of presenting his case to the team, and during their discussion of his treatment, which included surgery the following morning.

Later my resident said, “Your patient told me that he really appreciated your taking the time to talk to him in the ED.”

“Your patient…” I savored those words. This was the first time I felt I could legitimately use that phrase. I wouldn’t go so far as to say that I was “nondisposable,” but I began to see that, as a insignificant medical student, I might have one thing to offer Mr. Knight that my team’s interns, residents and attendings did not.

I didn’t make any of Mr. Knight’s medical decisions or perform his operation, but I took the time to listen to his story and get to know him as a person.

After his surgery, I saw him in the post-anesthesia care unit, and every morning on rounds for the next five days. I saw him take his first steps after surgery, and I was there to hear him say proudly, “I just walked all the way down the hallway.” Each night, I made sure to stop by his room before leaving the hospital.

Although I didn’t yet know how to treat Mr. Knight’s symptoms, I did come to know that he’s a baker who likes to bet on sports. For me, that was a win.

When he was discharged, I felt both happy and sad—happy because he was well enough to go to rehab, and sad because I’d made a friend, and he was leaving. I knew that he had so much more to say to me.

Walking with him to the parking lot, I couldn’t help wondering what was in store for him. When we arrived at his car, he hugged me goodbye. I can only hope that the people who care for him in future will be lucky enough to have the time to get to know him as well as I did.

And I keep thinking about those words: “Just go see the patient.”

Just going to see Mr. Knight taught me two vital lessons. First, that it is truly a privilege to listen to a patient’s story and help with their care. And second, that although as a medical student I might be disposable, I do have one thing that I consider nondisposable, even precious—and that is my time.

Barbara (Bobbi) Meyer is a fourth-year medical student at Albany Medical College. “I have never tried to have my writing published, but I was motivated to share my experience after attending Airway Stories during my emergency-medicine rotation at Maimonides, and after reading “Medicine With Heart: Why Words Matter” by Sophia Görgens.”

Comments

16 thoughts on “Disposable”

  1. Thank you for sharing this! Your warm heart and great sense of humor shine through. My first thought was, I haven’t been a medical student for fifty years and you just brought it all back–gaaaahh! But all that came after “Just go see the patient”… uplifting and priceless.

  2. Your story is so important! Thank you for taking the time to reflect, write AND share. Taking time, any amount, to be fully present with another, is invaluable. That you also learned it is valuable to you is equally invaluable. This is what prevents burnout. It is the core of “care” in healthcare. No matter how busy or pressed you feel, THIS practice of listening and being curious will always guide you to the heart of what matters most. You may find reassurance and resonance with this podcast: https://podcasts.apple.com/us/podcast/dying-to-talk/id1660221334?i=1000626469410

  3. Louis Verardo, MD, FAAFP

    Great story, Ms. Meyer. Sometimes we forget that medical students are our future colleagues and deserve to have a set of curricular goals for what they will be doing on our respective services. And you just demonstrated that the first curricular goal is to learn how to talk to a patient with the objective of creating trust sufficient to collect pertinent clinical information. To me, that is a skill as important as the procedural skills we need to learn, and you did an exceptional job at that particular element of your medical education. Best wishes for what promises to be a very good professional career in Medicine.

  4. Thank you for sharing this important lesson in listening and simply being present, in an environment that is chaotic, confusing, and frightening to the patient and family. Instead of just another old man on a gurney you saw him as a person and learned so much about him. Your brief connection no doubt contributed to his healing and being able to leave the hospital. As others have commented you will make a wonderful physician!

  5. I love how you persist through the awkward and difficult parts of starting a medical career to focus on what you can learn! Thank you for your story.

  6. What a lovely story- as you evolve in your training, make sure you continue to hold tight to the preciousness and the power of just sitting and listening curiously to your patients- it will always teach you so much

  7. This poignant story reminded me of the beginning of the book “Heartsounds” by Martha Lear, about her physician husband’s experiences in the medical system starting with his getting to the ER at the onset of crushing chest pain. He is starting to lose consciousness, but is aware that he has ceased to be an individual and is now being worked on by an organized and almost automated system- until someone puts a hand on his shoulder and asks him how he feels. He thinks to himself, just before he loses consciousness, that it must be a medical student, because they are the only ones who have not yet learned to become detached. Made me realize that even as medical students, we have something special to offer. The trick is how to not lose that something special.

  8. As a fourth year medical student, I resonated with a lot of the feelings you felt on your third year rotations. Thank you for sharing your experience, and I’m so happy to hear you connected with your patient in this special way. Hang in there – I’m rooting for you!

  9. Sandra Seyfarth Lechner

    All you had to do was pick up the pen, or keyboard and you wrote a lovely accounting of the importance of “Seeing” all of the patient. Well done.

  10. Thanks so much for sharing your story. You will become a wonderful physician, who understands the importance of listening.

  11. Beautiful story! I am so happy for the patient to have had you to ‘see him’ and to ‘hear him’. That is so rare in the hospital, clinic and even doctor’s office. I am also grateful it filled your heart too!

  12. Well done! Nicely written – and such a meaningful message, thank you!

    I would not agree that calling a student “disposable” is OK. Not at all – that’s really not OK. Certainly students are not essential to some technical aspects of patient care but even on Day 1 of medical school a student can play an important role as a team-member – just like you have shared here.

    I am reminded of Dr Will Bynum’s story of being made to feel shame in – I think – the OR when he was not able to respond immediately to some prompt. He was made to feel ashamed of himself. Unfortunately “shaming” has a long history within medicine – and definitely continues as a strategy to this day. Check out https://www.theshamespace.com/ and other similar efforts to counteract and minimize its’ use. Thanks!

  13. A lovely story of patient care–and you are not disposable. You are part of the next generation of doctors who will be taking care of all of us.

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