[my apologies if my first blog entry is a repost, but I truly believe that if there is one article that should be here, this is the one]
It happened during my internal medicine rotation as a junior intern, I was stationed at the dreaded 4-South wing where there was always an abundance of patients. I was already midway into my clerkship, so it wasn’t as bad as when I was just starting but still, I was irritated to know that there was a patient that was being transferred from the 4 – North wing. Great. Grudgingly I mentally went over the stuff that I needed to do as I rushed to meet the “new” patient: make an initial data base, make an assessment of what the patient might need and make sure the orders of the attending physician were carried out. It was already a common thing for some people who think or rather assume that they know more than you do or how to do your job as a junior intern, a lowly position as it already is, and it wouldn’t surprise me if this patient wasn’t any different.
When I came in to introduce myself I was greeted with a cold response from the patient’s relatives and nary a response from the patient himself, so I just excused myself and told them that I would be back at a later time, given that I had tons of other things to do than be treated as someone not even worthy to stand in their presence. It was later that I learned from a co- intern that the patient just happens to be a surgeon and his wife was a nurse. Great, just great I thought to myself, this was going to be one of those days.
But when I did get to know “my” patient better, I realized more and more how little I know, and how immature and uncalled for it was for me to be so judgmental. It is an overstated fact that people come in the hospital because they are sick, he was jaundiced, his abdomen bloated and needle marks from syringes and IV sites marked a large area of his arm. It was easy to dismiss him as just another difficult patient. Most of the time we are guilty of quickly judging others based on first impressions, we should not. When I learned more of his story I got to know that he contracted his illness in a most ill-fated manner. He got it while doing an emergency surgical procedure and accidentally cut himself, in the process getting infected by the patient he was treating. It so happened that the patient had hepatitis. People come hospitals because they are sick and most of the time it’s not their fault that they are sick. How easy we forget.
In one of the daily rounds with the consultants we were told that his condition was serious. We were told that medically, the good doctor had little chance of survival. Those were the facts, the awful truths that were shoved in my face. In my mind I was thinking, no, that can’t be right. I was in denial, but this was a liver specialist speaking not only from years of experience, but from someone who has seen it all before. Death was imminent. Still, I prayed for the best. It was all I could do.
I left them one morning telling them that I was to attend a convention somewhere else. It was in a way a reward for the help I did for my bosses. I was excused from hospital duty for two days, I went home very tired. My frail body begged for sleep. Half awake, I received a text message from my fellow intern who was on duty that night, too tired to think straight I made an excuse although I could have gone on duty that night. Not knowing any better I stayed glued to my bed and slept ‘till morning.
When I reported for duty the next day, my first instinct was to check on how he was doing. Curiously, his door was half open, and I thought that they might have transferred to another room or something. Then it hit me. He was gone, the nurse on duty told me. If memory serves me right he died of cardiopulmonary arrest. I could not be sure. I wasn’t there when he died, I should have been, I but I wasn’t. my vision started to become blurry as tears started falling from my eyes. My co-intern was there and cried with me as well, saying he’s gone, he’s gone. What touched me most was when a relative told me that just before it happened, the good doctor asked for me, he wanted me to be there. And I wasn’t around.
Time and time again we are reminded by our superiors that we shouldn’t get to attached to our patients for it might affect our supposedly objective assessment of them. But we are only humans I suppose, imperfect, bound to make mistakes, frail and capable of feeling emotions.
I cried. I couldn’t help it. One of only two times that I had cried because a patient died, people whom I was not even remotely related to but felt their loss. I felt a pang of guilt for I was not there when my patient needed me the most.
In the end I am still thankful that I was given the opportunity to have known such a great and honorable man and that no matter how short our time together was, he was able to impart what four years of medical education sometimes fail to teach: that the measure of a good doctor is not in how many patients you are able to treat nor how much money you make not even how many letters you add after your name. Sometimes it all boils down to how we use our lives for others.