I don’t think that anything can truly prepare someone for what I experienced for the first time during a patient interaction. It was time for another chance to talk with a patient for my ICM class (Introduction to Clinical Medicine). I had already met with two on previous days that had left me feeling wonderful about these experiences. And this time, it was supposed to be even better since I was going in with the entire group of students that I had been paired with for the class and we were going to see two patients. We were ready for anything.
Well… almost anything. The first patient that we saw was comfortably sitting in his chair and resting, but there was this certain gleam in his eye. I was chosen as the individual to interview the patient first, so I stepped up and began. I knew not to do it, our preceptor (physician that graciously volunteers to babysit a group of medical students while they learn to talk to patients) had warned my whole group multiple times, but I still started with the question, “So, what brought you into the hospital today?” The patient’s quick reply was, “Now that’s a funny question. An ambulance brought me in of course.” Our preceptor roared and we all soon followed. The rest of the interview was filled with similar quips, but even if it hadn’t been, I would still be saying that it was a great opportunity to talk to a patient. I enjoy conversing with them, and I certainly enjoyed knowing that the patients we had seen so far were most likely going to get better, go home, and live their lives. This patient was no different; I came out feeling on top of the world.
However, that was not the case for the second patient we saw that day. When we entered the room, the melancholy atmosphere was almost palpable. Nevertheless, we (and by we, I mean the next person who had been selected to go) began to interview the patient. It was distinctively different. Yes, everyone else that we had interviewed was sick, they may have had a difficult time speaking, but this patient’s voice was heavy, as though he were bearing a great burden. At the end we left the room to go discuss the patient’s stories. But, the experience became much more saddening upon discussion with our preceptor.
The discussion of the first patient was just as light-hearted as the patient had been; however, as we began discussing the second patient, all that my preceptor had to say was, “It’s bad.” I knew what that meant, and I was instantly floored. “He will probably die,” I thought to myself. I couldn’t escape that feeling for the rest of the discussion. Certainly, I knew before I had even decided to become a physician that not every patient could be saved. This fact is fundamental to life, and I had watched my grandfather pass away. But no matter how often a person receives “exposure” (if that is the correct word), nothing can prepare an individual for that instant realization that this person may not be alive for much longer, for that impending feeling of death. So it was with me.
Looking back, I still enjoyed both interviews, and I still enjoyed talking to the patients, but the second interview was definitely an experience I will not soon forgot and will also be exposed to many more times. The feelings that I had at the end of discussing the second patient’s story remind that I am still human and that I still care about the patients I see. Yes, it’s only the first year, but I hope that I never lose these feelings because they are what give me passion to save everyone I can and to care, in the best manner possible, for those that I can’t. If these feelings stop, it will be time to hand in my white coat.