I Am Just A Medical Student

She’s well into middle age*, but appears just days older than 40. Her eyes are sunken, tearful, worried, anxious. She tells me about her grandchildren, and how she just visited them out west. She came to the hospital straight from the airport. She’s worried.

She’s worried because her shortness of breath hasn’t gone away for over a month now. She has had breast cancer, and opted for a more conservative approach – a lumpectomy with axillary node biopsy without radiation. She’s admitted, and gets a chest x-ray and a CT scan, which show a pleural effusion [excess fluid in the lungs] with what looks like nodules in both lungs. ‘Likely represents metastatic disease,’ [the spread of cancer from one organ or part to another non-adjacent organ or part] reads the official radiology report. She has already been told, so I don’t bring it up again.

I am just a medical student, I think.

On the second day, she undergoes surgery to evacuate the effusion, and her lung is biopsied. Now, we wait for the pathology report. I visit her every day as we wait for the biopsy report to come back, sometimes two or three times. I’ve met her husband, and we know each other by our first names. Her children are beautiful people, just like her. They ask me questions, and I keep my answers limited to what I’ve read in the chart. They never ask me about the cancer. They know what the radiology report said, so I don’t bring it up again.

I am just a medical student, I think.

She never complains. Not from post-operative pain, not from shortness of breath, not from coughing, not from anything. I take my time with my physical exam, ensuring that I don’t miss any tenderness. I don’t want her to suffer unnecessarily. “Surgery is painful,” I tell her, “make sure you let us know if you are in pain.” She agrees, but never complains.

The nurse corners me one afternoon, and asks me, “Is there any way to put in an order for morphine PRN (Pro re nata- Latin for ‘as the circumstance arises’) for her?”

I am just a medical student, I think.

“Why?”, I ask.

“Because when her family isn’t here, when she’s alone, she cries. She’s in pain, she’s scared, but she’s a silent sufferer.”

Oh.

I am the first person she sees every morning, and I try to make sure she’s comfortable. I offer extra blankets, water, anything I can do just to make sure she is as happy as she can be. She appears more and more cheerful, and I spend what seems like hours holding her hand and chatting about life, the weather, her family, my family, my future goals, my girlfriend. I show her pictures. We laugh. We smile. But her eyes remain anxious and worried.

She says she likes my bowties, so I make sure to wear one every day for her. And I tell her, “I thought of you when I put this one on this morning.” She smiles through those tearful, anxious, worried eyes. I smile back. And that is enough to make my day.

I walk in with my bowtie and smile around 6:30 pm. She just got back from the CT scanner, and her family is around her bed, as per usual. I visited, just to say good-bye for the day. The sun dips a few degrees further west, just enough to peak through the curtains, and her husband turns to me and says, “Edwin, thanks for bringing the sunshine.”
I stand there, in a loss for words, armed with little more than a bowtie and a smile.

I am just a medical student, I think.

Fred Rogers, Mr. Rogers said, “there’s something of yourself that you leave with every meeting with another person.”

*Some details and identifying characteristics have been changed to protect the privacy of the patient and their family.