Seeing Death Differently

Anthony Rudine -- A classmate of mine recently expressed some concern that he feels grossly unprepared to treat patients. He said it makes him very uncomfortable to know that he has to treat patients in the future.

Of course, the simple reply is, "Well, you are not supposed to know how to treat people yet, that is what we are here for." However, a deeper question must be asked.

Should he feel more prepared to treat people at this stage of the game? Is the current system of medical training the best it could be? Are all doctors prepared in the same way?

I know that the easy way to ensure proper training for all future physicians is the US medical licensing exams, followed by residency. However, is this the best way? My school is currently changing the curriculum from a traditional "separated" curriculum to a more systems-based philosophy with earlier clinical experiences.

As I thought about what my friend said, I realized that I too, feel some anxiety when I realize that I will be responsible for people's lives in the future. This, however, is not my biggest concern – it's dealing with the families of the patients and the patients themselves when I have no good news to bring.

I cannot imagine what it is like to tell a person that they will die, or that they have an untreatable disease. I cannot imagine telling their families that their relative will not make it to Christmas time.

When I was home for the break, I spent a lot of time with my grandmother, as she was staying with us for a couple of months. We spent a good deal of time talking and just enjoying my time off.

However, our talks were always tainted. As you might remember, my grandfather passed away a couple of months ago. Thus, much of my time was spent talking to my grandmother about her husband. This was difficult for me.

I have talked to my grandmother many times before, obviously, but there were many times where I simply had nothing to say. I could not find the words to comfort my grandmother about losing her husband of 40 years. What was I to say?

In light of this, I have experienced what it is like on the other end of the spectrum. Outside of the hospital. This is the first time I have experienced the family end of a death since "entering" the medical field. And to say the least, it is different.

I often catch myself in the hospital looking for the "interesting cases," the "rare cases," and the good teaching cases. I think all of us do, for that is the reason that we are in medical school – to catch the zebras and treat the horses.

However, spending time with my grandmother over the break has helped me realized that there are no "interesting cases," just interesting people. People with families just like mine, and grandmothers just like mine who will have to deal with what I tell them long after I leave.

This weighs heavily on me. I catch myself thinking – could my grandfather's physicians have done anything differently to help my grandmother? What can I do in the future to help others' relatives with the burden of losing a loved one? Can I do anything?

It bothers me somewhat that, as I saw my grandmother for the first time since my grandfather's passing, I had nothing to say. I knew that I should say something, anything, but I simply could not. I think I did not want to see her cry. Maybe I did not want to cry myself.

Eventually, however, I began to ask her about her husband and just listened to her open up to me – what a weight that lifted off my shoulders.

As a result, I now know this – just allowing someone to open up to you is a major part of the healing process. As a future physician, I pray I will find the time during my likely busy schedule to form relationships with my patients and their families that will allow them to trust me enough to open up and talk.

Now that I have seen both sides of the equation – before and after entering medicine – death has changed quite a bit. As a medical student, I often forget about the families that are awaiting the arrival of the diagnosis and how that will affect them in the future. My grandmother has taught me to never forget that again.