I’ve written before about my medical student journal, and how looking back through it reminds me of the reasons I went into medicine and highlights some of the experiences that have had the biggest impact on me. There is one journal entry I go back to more frequently than others. Everyone has certain patients that stick with them forever, and over ten years later, this patient’s experience continues to influence how I practice medicine on a daily basis.
During my inpatient medicine rotation, I had a patient that I took care of for almost an entire month. I remember his face and voice so clearly - he was a patient with metastatic lung cancer in his late 60s, who had decided to forgo most medical treatment. When I rounded on him daily, there wasn’t much to do medically except control his pain, so I would just chart his vitals and then sit down with him and talk. Every morning when I came in, he would be sitting there with a cup of coffee and the newspaper, and would talk to me about current events, life in the military, his career, his daughter, and his rationale behind deciding against further treatment.
I cherished those conversations, and would often go back in his room to talk during moments of downtime during the day. He had no visitors, and had so much to say, and I wanted to give him a chance to say it. I enjoyed his sense of humor, and learned so much from his perspective as a patient. He was brutally honest, and shared with me everything that he thought we as a society did right and wrong in healthcare. As someone entrenched in learning how to provide care, it was eye-opening for me to really see the other side of that from the patient’s perspective. As the month progressed, so did his condition, and during his last few days, I found myself unwilling to leave the hospital, worried that each conversation would be the last. I stayed late, and then went home and spent most of the night wondering what was happening at the hospital and whether he was scared or in pain. I was terrified of when I would walk into the hospital and find that he wasn’t there.
Of course, one day, that happened, and I was devastated for days. My attending physician and residents shared their stories about the first patient they lost that had meant a lot to them, and I slowly came to terms with the fact that this would be a part of life in medicine, and that I had to develop coping mechanisms that allowed me to function in my life outside of medicine.
I moved on, like we all do, but that patient changed who I was as a physician, and I look back on my memories of him with a lot of fondness and a sense of gratitude. In addition to teaching me how to deal with the loss of a patient, he is my reminder that behind each patient and their medical condition is a lifetime of stories and relationships that impact their health and their medical decision making process. He is my reminder to see the patient as more than a chart and test results, and approach each interaction with empathy and an opportunity to learn. Most importantly, he is my reminder that it is a privilege to be a part of a patient’s life. On my harder days in medicine, I remember him, and am so thankful for my role as a physician.
Nisha Mehta, M.D.
Dr. Nisha Mehta is a physician and writer with interests in physician wellness, medical education, and health policy. Follow her on Twitter @nishamehtamd or on Facebook at www.facebook.com/nishamehtamd.