Lacing Up my Dancing Shoes

“Don’t let medicine change who you are.” It was almost eerie how those words were becoming so common during feedback sessions. “Don’t stop being yourself,” cautioned my senior resident. I laughed initially at these warnings, and then quickly probed preceptors and residents further as to what preceded these warnings. I knew who I was and, considering how stubborn I am, I could never imagine changing my quirks. What was it about the process of completing medical school and residency that warranted such warnings? Any medical student is well aware of the picture that residency painted: tired, worn-down people whose names were preceded by “Dr.” I had to wonder why my senior residents and attendings continued to comment on my personality as if I too would soon be broken and molded into someone new.

I can’t help but think of my first patient I followed during my medicine rotation. She was not much older than me and had already garnered significant attention by other residents when they read through her labs. Her physical exam and lab findings pointed toward a new diagnosis of autoimmune hemolytic anemia. The whites of her eyes were instead neon yellow and the results of her hemoglobin were accompanied by bright red exclamation points: 3.1. “I wonder if that’s one for the record board?” a resident chimed. For me, I shook my head as I knew she was more than a number chalked up on a resident lounge whiteboard of vague yet extreme lab values. Up until the day she was admitted, she had pulled herself out of bed to try and chase after her kids, even when her fatigue was unbearable. I couldn’t help but be in awe of the fact that while others complained of fatigue when only slightly anemic, she had been mustering up any strength to care for her family prior to admission. Over the next few days, I had cooed over the many pictures that she would show me of her four kids, talked to her mom over speakerphone, and discussed in length our favorite cafeteria meals. Each morning, the resident and I would run through the results of the morning labs with our patient. She would vent frustration of how slowly her hemoglobin was ticking up. Over the next few days, we chatted about her family, work, or favorite hospital meals as she remained tied to her IV pole for required transfusions. On day six, with a smile across their face, my resident announced that the patient’s hemoglobin was 7.0. I couldn’t help but throw my hands up and boogie, which was met with laughs from all in the room. This result was a small victory but one that warranted some dance moves, especially for a patient I had quickly grown fond of. It would continue to be a joke on our team as to what results would warrant a dance from me, which I was always happy to provide.

Unfortunately, not every patient interaction has a happy ending. During the concluding weeks of my medicine rotation, I was seeing an elderly patient during his fourth admission in six weeks. His recurrent pleural effusions were thought to be a product of persistent pneumonia, but further workup during a previous admission ultimately revealed cancer. His breathing issues were further complicated by his progressive dementia as he was most distressed with his breathing during confused episodes, warranting an emergency department visit. During this admission, our team had to deliver the news that no further options were recommended except for hospice care. Before we entered the room, I was fearful that I would not be able to control my emotions and match the somberness and strength that I assumed all doctors showed. To my surprise, I watched as my resident’s voice cracked while sharing the news with the patient and his wife. Being an emotional person myself, I quickly joined in on sharing tears as everyone in the room passed around tissues. This somber moment was broken by the familiar soft smile of our patient, as he held his wife’s hand and said “let’s go home.” When debriefing with my team following the conversation, I felt reassured in my ability to work in medicine as my resident and attending physician shared stories of crying with other patients. Medicine allows one to take part in many positive conversations. I, however, was grateful to take part in the difficult ones as well.

I try to imagine myself after residency, having my own practice and patients. Will I still be eager to share great test results with my patients? Will I want to take a second to boogie with them? Will I be vulnerable and shed tears with them and their families? I think about the physicians I have worked with thus far. Have they changed since being third-year medical students, caught in between who they were before their training and who they must become to survive it? I hope that they haven’t changed much since their time as medical students and still have their own quirks that they share with patients. I thank my residents and preceptors for recognizing my quirks and for reminding me to be grateful for these traits. I don’t plan on letting medicine change who I am and, frankly, I have no intentions of losing my dance moves anytime soon.