Dear Ms. S,
I’m honored to have known you, I’m glad I had a chance to hold your hand before your surgery, and I will forever remember you as my first patient who passed away.
Within the first few seconds of meeting you, I knew you were a sweet person and had a wonderful, giving soul. I hope you are at peace where you are now. I hope you are no longer suffering.
Veronica Faller
For my internal-medicine rotation as a third-year medical student, I was placed at Boston Medical Center, a large urban hospital that serves patients from all walks of life. My team included an attending, a pharmacist, a resident, two interns, two of my classmates and me.
Here is a snapshot of morning rounds with some of the patients I met, and of the emotions I experienced during my first weeks on the general-medicine ward. I refer to the patients by their illnesses not only for confidentiality but also to show how we sometimes identified them, despite our best intentions.
My First Patient: She comes in with altered mental status–confusion, sleepiness and memory loss–and she does not speak English. My resident tells me
Ralph B. Freidin
Every fall, medical schools welcome nearly 20,000 college graduates. They arrive anticipating endless hours of lectures, too much coffee, and infinite facts to memorize. There is one thing they do not expect, however. I know. Forty-nine years ago, I was one of them.
The first day I walked onto the wards was in spring of 1967. I was in St. Louis, doing my second year of medical school. Previously my presence in the hospital had been restricted to the cafeteria. I was twenty-three, had only examined the eyes and ears of my classmates–never a patient–and was about to perform an unsupervised cardiac exam.
Anxiously, I waited with an instructor and three classmates outside the room of our assigned patient.
Nat Fondell
“Hey, Rick. They warned you about me, I hope?”
My routine med-student opening line elicits a slight smile from my balding forty-two-year-old patient and the patient’s wife. As we shake hands, I continue the script.
“I’m Nat–the medical student. What brings you in today?”
“Well, I’d like to transfer my care to this clinic. We’ve brought my medical records.”
Together, they heave stacks of papers onto the desk. Rick’s hands slide back into the pockets of well-worn work jeans.
“Can you tell me a bit about yourself?” Classic open-ended question.
“Well, I’ve been seeing specialists for years about my headaches. That explains most of the paperwork. High blood pressure and high cholesterol. Plus my family has
Alexandra Rosenberg
1. (PHQ-9: Screen for Depression)
“Depressed? Course I’m depressed.
My wife died ten years ago.
My son? Well…
He does the best he can for me.”
2. (DNR)
“What’s that you call it?
In-tube-ate?
No ma’am.
No way to die.
Just call my daughter,
give me some pills–
I’ll go easy.”
3. (Suicide Attempt)
“I’ve got two voices in my head
Chuck and Butch
Chuck’s not so bad, but Butch….
I like Chuck, I don’t want him to go away.
But things got bad,
My girlfriend left me.
My head was
a too-loud radio station
–can’t turn it off.
I
Caroline Wang
About the artist:Â
Caroline Wang is a medical student at Drexel University College of Medicine (DUCOM), completing the MD/MBA dual degree program. When she’s not studying, she enjoys running and weightlifting to stay in shape. She is involved in medical humanities through her participation as a member of Doctor’s Note, DUCOM’s a cappella group, and of Drexel’s Medical Humanities Program.
About the artwork:
“During my first year of medical school, I spent a lot of time, from early fall until
Anne Whetzel
It’s two months into my second year of medical school, and I’m at the clinic, preparing to shadow Dr. Neiland, a primary-care physician.
I didn’t want to come here this morning.
Yesterday, one of my preceptors decided that it was my turn to be “pimped.” Pimping, in medical education, is when the preceptor asks you questions until you get one wrong. Then he asks more questions, highlighting your ignorance. Theoretically, this ensures that once he tells you the correct answer, you’ll never forget it. This works for some students, but not for me. I get defensive, and the right answer, whatever it is, goes in one ear and out the other.
Sanyu Janardan
I was a first-year medical student, starting my first afternoon at an outpatient clinic as part of an introductory course in clinical medicine. My white coat was freshly washed; I had a rainbow of pens in one coat pocket, and my shiny name tag dangled from the other. I only hoped that I was as prepared as I looked.
I entered Mrs. Carr’s room. A fifty-five-year-old woman, she sat gingerly at the edge of her chair, looking ready to get up at any moment, as if the appointment were already over. She gave me a cursory glance, then went back to folding and refolding the bus-ticket stub in her hands.
I asked a well-rehearsed question: “What brings you to our
Kristie Johnson
One cold February morning during my third year of medical school, I walked through the entrance of the rural hospital where I was doing a nine-month rotation, and made my way to the nurses’ station. Feeling the warmth return to my face, I set down my coat and bag and hung my stethoscope around my neck.
The charge nurse, Barb, waved me to her computer.
“Kristie, you have a patient.”
She shuffled through papers, grabbed a blank chart and placed the patient’s admission note on top. When she saw the name, her face fell.
“Ah, it’s Peggy.”
Matthew Webb
“Matthew, go see this lady about her breast mass,” says my attending physician at the clinic where, as a third-year medical student, I’m doing a family-medicine rotation.
Okay, I think. I’ve done my ob/gyn rotation; breast masses are no big deal.
I don my short white coat, freshly baked from sitting in the back of my car as I drove to work on this oppressively hot morning. As I sling the stethoscope around my neck, I feel my inner voice (my constant companion amid the stresses of medical school) gearing up, ready to offer insights, questions, distractions….
Allie Gips
tucked into the chaos of the emergency department
is a single room with stirrups, a floor spackled with blood,
& a woman whose face betrays nothing.
the bodies of all those i have touched who have then
died pile before me like so many broken eggshells
so i stand against the wall to distance myself from her
& her cramping uterus, her dark red clots that fall
like sleet, her blank eyes that stare strictly at the ceiling
while we busy ourselves with machinery: the speculum,
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