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No Med Student Is an Island
Ali Tabatabaey -- For most of the X-generation robots attending med school during our times, life is about day-to-day patients, disease, prescriptions, discussions, and the whole thing all over again. Not many of us dare to disclose our human emotions, and even if we do have such feelings, it’s something we hold to ourselves for those lonely moments when no one is around to see. And so the real tragedy of being a med student unfolds: the lonely human, facing a world of emotions!
It seemed like a normal shift, checking on the patients, organizing the files, writing notes, going to the interns’ room to rest, seeing your colleague crying her eyes out…
“I’m sorry. Did I bother you? I’ll come back another time.” It was like being shocked with 10000 volts of electricity. She’s one of those disciplined interns who do the job and leave out the accessories, hardly losing her frown while at work. I was stunned.
“No. Thanks, I’m ok. I have to get back to work anyway.”
“You don’t look OK. You can go home if you like, I’ll cover for you.” And I’m one of those people who just can’t keep their nose out of people's business! “Is there anything I can do? I might be able to do something if you tell me what’s wrong.”
“Have you seen the patient in room 9?”
“Yes.” A 2.5-year-old girl who has spent the last 10 days in a coma. 12 days ago, she came down with a fever and vomiting. Her condition deteriorated by the minute, and now she is brain-dead. It was probably viral encephalitis or a complicated tumor, but no one knows for sure. Her family has not allowed further investigations. “What about her?”
“She came in a couple of months ago with a febrile convulsion. She wasn’t my patient, but I remember her clearly. She was a beautiful girl, bending down the side of her bed. I walked in and called her a naughty girl!” The stream of tears running down her face refused to be controlled by the pathetic attempts made by the wet tissue in her hand. “Is she really dead now? How could she turn like this in two days? We probably missed her diagnosis the first time.” Frustration, anger, sorrow and many more emotions flooded her. I was muted by the enormous emotions overwhelming her. I had nothing to comfort her. “Why her? Why so fast? Isn’t there any hope? Isn’t there any justice?”
The truth is that the girl is in fact dead, at least as far as the neurologist is concerned. There is nothing we can do except to keep her body alive. The story had become more tragic now that I knew a bit more about her, but still there was nothing we could do. We had been beaten by a virus. My fellow intern knew all this too but … In such times of hopelessness, we need someone stronger to hang on to. All I could think of was praying at the holy shrine. Maybe this way she could calm down a bit. She accepted.
I guess all of us X-generation robots attending med school still have a touch of humanity deep down inside. No matter how rock solid we try to be, the so-called everyday events around us are so powerful, that just when you least expect it, they will push you over the edge. One day we will all break into tears. It’s just not the same day for all of us.
Two days later, room number 9 was empty again.
March 21, 2007 | Permalink
Comments
Yikes. What a sad story. But true, unfortunately; the same story's repeated all across the world, every day in thousands of hospitals.
It's precisely because of pain like this that man searches for a greater meaning, something bigger than himself. Thanks for sharing, Ali.
Posted by: The Angry Medic | Mar 21, 2007 7:31:35 PM
I had sort of a similar experience during my surgery rotation two months ago. Everything that was happening in the ER felt like a dream. In a matter of 30 min, a young boy my age was rushed in with a gunshot to the head and was declared brain dead right then and there.
Sad doesn't even come close to describing the situation, especially of this little girl. I know that this will not be the first of such experiences for me, but I do know that with each, I am realizng that there is more to this world than what doctors can control. If you can get a hold of the book "Dying was the best thing that ever happened to me" by William E. Hablitzel, you should read it. It is inspiring and heartwarming and necessary for a physician in training.
good luck
Posted by: | Mar 27, 2007 2:59:23 PM
sad sad sad but it happens every single hour somehwere in the world. We all get to have those days no matter how much we try to avoid it hwether running to certain specialties that may seem to have less of such cases; its inevitable.
Posted by: Watch your mouth | Mar 27, 2007 5:27:05 PM
We have to learn ¨The humanistic ability of doctors to use empathy to apply their knowledge to patients, the emotional link that unites sufferer and healer¨¨-
But we also have to learn to Draw lines. We as future doctors are expose to all kinds of extraordinary cases like the one described previously. (patients alive now, dead the next second with no apparent reason). I dont think we have to become Robot-like doctors with no feelings. I believe we have to give patients a human touch of empathy, taking care of not getting involved emotionally too much.
Adrien Brutus Gonzalez
Montemorelos University Medical School (2nd year)
Posted by: Adrien Brutus | Mar 28, 2007 11:14:07 AM
I am of the opinion that to practice competently and compassionately any facet of clinical medicine one is rightly effected by outcomes directly or indirectly resultant from their action or inaction. Balanced appraisal of a poor outcome and in this case the ability to both grieve for a patient and move forward to treat the next is perhaps the hardest task in ones professional life and no text book will tell you how to do it. I agree that such moments will come to all that practice medicine well and should not be looked upon as a weakness or failing.
Posted by: UK Doc | Mar 28, 2007 12:24:59 PM
One of the most important abilities of a doctor may be to be compassionate and feel the feelings along with the patients, but be able to function in the same time. Difficult sometimes, but worth it.
Posted by: Lina | Mar 28, 2007 3:17:33 PM
great piece.
heartfelt and sincere ali.
this is the kind of honesty medicine and humanity needs to read.
Posted by: london medic | Mar 28, 2007 3:52:00 PM
Hi!!
Thanks for sharing your experience with all of us.
I'm a med student from Chile, I'm in my last year... I'll be a doctor soon. And it's such a responsability to deal with all our emotions...
Every day we are faced with human pain, physically and emotionally. And I guess that's exactly what gives medicine its value. Because if you live it in any other way, it looses its sense, its reason to be. Maybe it's harder to work that way, but being in touch with every human being in the way it's whats keeps me going on in this storm of knowledge and work we live in.
Don't ever loose that. The world needs doctors that feel and undertand.
Posted by: Maria Paz | Mar 28, 2007 6:30:16 PM
This is indeed a tragedy for one who is at such innocent stage of their lives. I guess it maybe useful bare in mind that death may sometimes be the best cure. The book Life After Life by Raymond A. Moody scientifically suggested that life after death may not be as bad. So, reading that book may help doctors to look at death in a more optimistic way.
Posted by: Dr.Dan | Mar 28, 2007 8:00:59 PM
we have to understand that there are things which we cannot control and we need to accept these things...but a life that could have been saved should not be lost..
Posted by: prads | Mar 28, 2007 10:44:13 PM
It is ok to grieve in such situations - if you didn't what sort of Dr's would we be!
Posted by: LeaK | Mar 29, 2007 12:43:26 AM
Such a disgrace, yet we couldn't do anything for her since she'd been brain dead, at least we can support each other - like you to your intern -
Remember doctors hardly ever have the cure but at least they support their patients.
Good luck
Jessica.
Posted by: Jessica | Mar 29, 2007 3:34:45 AM
Something similar happened to me while in NICU rotation. I was the clerk around the time 2 babies died soon after birth after efforts were made to keep them alive.
Demerits or no, I could not make myself do any paperwork for days. People got me to drink wine, and I'm not the drinking kind.
EK 8 )
Posted by: EK | Mar 29, 2007 5:25:16 AM
Truly a touching story. A doctor can somtimes only be a mute spectator. Oppotunities do get lost. only thing we can do is hope the mistake will not be repeated and pray for the loved ones of the deceased.
I am in intern in India similar situation happened with me when i was posted as an surgery intern. The patient had intestinal obstruction and was operated and a Meckel's was fond as offending agent and was removed. My duty was to monitor him post-op. He was stable hemodynamically for 2 hrs so was shifted to ward. i waited till he came out of anaesthesia. After coming out of anaesthesia he did the most touching part uptill now of my life, he told his mother that because of the resident and me he is alive. Two days later he was dead. It had happened when i had completed my posting. Somtimes i just wish i could have been there, could do somthing to save him. Somtimes things are not in our hands to and there is bigger healer up there somewhere.
Only thing we can do is do ourduty dilligently, sincerely and leave everything else in his hands.
Posted by: Sushanth | Mar 29, 2007 9:44:31 AM
It is hard to watch, when our patients to get worse and worse, no matter what we do, and it is wanderful, when we see them recovering rapidly (or slowly, but RECOVERING!) In both cases it feels like the patient is our closest relative and our future and happiness depends on his/her wellbeing. It means, we still care. But I have some "good" news: most of us will lose this ability (and very soon).
Our profession does not include only inspection and treatment of a patient lege artis. We have to understand the patient, but even true understanding does not always lead to cure.
There is a choice: whether we care or we don't.
The second choice is more convinient and for very many of us - the only possible, in order not to harm our mental helth.
Posted by: Una | Mar 29, 2007 12:12:08 PM
This is what being a doctor is about. This is why I want to do medicine. This is real.
Posted by: Sandy | Mar 29, 2007 3:30:48 PM
Gosh Ali, i´ve just had kind of the same experience, with a neonate, it´s just so overmhelming from time to time so we´ll end up spirit broken as long as we dont accept the fact that being a doctor is not just about trying to heal the body, but to become a "heal" for our patient´s soul. By last I wanna say that the biggest support for a "doctor wannabe" like us (interns) will always be your family, so keep hanging on and never forget that you are a human being!!!!
Posted by: OLIVER V | Mar 30, 2007 12:15:02 AM
Just trust in Jesus if the case go beyond your ability ask him to help and he will help instantly
Posted by: kingsleybadu | Mar 30, 2007 4:37:01 AM
To you, Gentle Reader: There is a song by Wayne Watson called "Home Free", from the album by the same name... It's been a blessing to me and to my friends, and I recommend taking a moment to listen to it, especially if you or someone you care about is hurting.
It's ok to be human. Our emotions, even the painful ones, are a great blessing. Don't try to smother them entirely; such a self-cannibalization would be a tremendous tragedy.
Posted by: Kristine | Mar 30, 2007 7:28:05 PM
it's a very sad experience.when a patient, like this girl, died ;we cried with his family. maybe it's wrong but it seemed to be the right and only thing that we can do..(a 8 year old little boy in coma with a fungal infection in his brain and nothing else left to be done)
our job is very difficult but i think we must never lose these feelings because we need them..
Posted by: funda | Mar 31, 2007 1:17:41 AM
You are right Ali. The life of a medical doctor is full of untold emotions. I believe all my colleagues in University Of Ghana Med. School agree with me. But believe me great guy,and all those who may be reading this short piece, that in Christ is strength. We do have emotions but Christ keeps us in motion. Stay blessed.
Posted by: RAYMOND PAPENFUSS OWUSU-ANSAH | Mar 31, 2007 3:45:48 AM
i'm a chinese medical student in los angeles.
i'm moved by this piece in it's connection to the reality and humanity of practicing medicine. i'm ever so glad to hear us "med student robots" to be people too.
in the school of chinese medicine that i am learning there is great emphasis on the emotional (and holistic) development of the doctor. this discipline ranges from the development of strong immune system functions to the ability to extend appropriate and compassionate human emotion - to ones patients and to ones self.
i'm glad to hear "you guys" (w.med students) working on the same things! perhaps you would be interested in some of the practices chinese doctors have been practicing for a while.
you can contact me if you feel it would be helpful.
Posted by: baylen slote | Mar 31, 2007 8:02:59 AM
Yea, it is one of those moments when we realize that no matter how we try, some cases will always be above us. Only some supernatural power could understand why. We could only give our empathy, professional counselling & comfort the family. We are so full of emotions than we would want to believe.
David R. Tlhabano
5th Year Med Student
The University of the West Indies
Posted by: David Tlhabano | Apr 1, 2007 5:59:54 AM
Sad Story =( but that's life. Not one of us will remain in this world forever. It just so happen that the kid have to go first. I think its God's will and there's nothing we could do about it.
Posted by: Sunshine | Apr 1, 2007 9:11:50 PM
To all you, dears, who have posted so far: have you not read Darwin ? or have you forgot it all too soon ?
It is simply called overproduction of individuals , in any species, why should OURS be exempted from this showing once again its superiority ?
Anyways, poor parents, maybe the little thing is way better off where she is now.
God rest her in peace.
Greta.
Posted by: Greta | Apr 3, 2007 11:43:19 AM
Thank you for sharing a great story...It's good to know that todays so called "robot" doctor can still feel. I think that's the most important part. If we don't care about our patient we might as well give robots our job instead of making ourselves crazy trying to remember all the differential diagnostic and treatments. I'm still in my 3rd year of medical school and it's good to know that there are still doctors that are human even after what we have to go thru..that's very comforting...and to greta that just sounded too mean!!!
Posted by: Dla | Apr 3, 2007 1:40:42 PM
what can i say?it's really sad though but its the LORD who gives and takes away.We medics are human beigns as well and as such our emotions cannot be utterly neglected. In those moments there's the need to commit ourselves and the patients to the supreme beign ie GOD for strength or courage to carry on.
Posted by: AFUA GYAMFUAH OFORI | Apr 7, 2007 5:24:15 PM
There is a human inside every doctor
There are feelings inside every human
But,
Doctor is a human who could handle his feelings
That's why we were tought of "EMPATHY"
Posted by: Ridma Jayarathna | Apr 9, 2007 8:08:36 PM
for sure it is a lot awful but i would like to tell you that i am a christian and i believe with all my heart that My God is there for the HEALING in moments like this and it brings me hope and certainly after joy. my only Sadness in such situations is that i didnt take time to share the Good News of Jesus eventhough God will be whispering that to my heart the whole time.that's why i want to profit as a medical student( 5th year out a 7 year course in Cameroon)to bring this ONLY true solution found only in JESUS.He SAVES and gives LIFE.something i have recieved. I know scientists like us dont believe in GOD more even in god.we are all too rational and rationalize everything but as much as all of this may seem foolish to you, draw close to GOD through JESUS cause he is the solution to all of this. you may try on your own but i dont want to discourage you; you will keep trying!!!! pLease dont rationalize this and know i dont believe as a means of escape to this world. this is REAL. GOD BLESS YOU and smile
Posted by: arnold | Apr 10, 2007 8:37:51 AM
Someone mentioned the book "Dying Was the Best Thing That Ever Happened to Me" by William E. Hablitzel, M.D. It should be required reading for medical students - at least then one of the books we have to get would truly help us become doctors. He came to our school to talk. The stories that he tells about patients and medical students hits home, and gives me hope for the future.
Check out his web site. You can get the first chapter of the book there free. http://www.DyingWasTheBestThing.com
Posted by: Zach | Apr 21, 2007 3:15:17 PM
death's sad, i agree but it's a whole lot better than being a vegetable. i once had a neonate who had kenicterus, then died. i hurt so bad cos that was a 'precious baby'. then i stopped being sad cos life would have been miserable for him. bottom line, there'll be times when we'll hurt but let's pick ourselves up n better doctors cos of that. hang in there!
Posted by: o'tega | Apr 26, 2007 5:59:16 AM
