Mr. C was the first patient I saw on my required general surgery clerkship.
He was a young man in his thirties who had been found down in front of a bar with multiple injuries. On the way to his room, the intern whispered to me that the operating surgeon had found at least twenty individual stab wounds on this patient during his emergency surgery. He was now stable and several days post-op and we were on our way to change some of his wound dressings. He had something around eleven wounds we had to prod and repack, all located around his chest and abdomen. In addition to his multiple stab wounds, he had a large chest tube placed in one of his lungs. Every movement, even breathing, was obviously uncomfortable for him. The intern and I quickly got underway, trying to distract the patient with innocuous small talk. The verbal anesthesia worked until we got to a wound over his midline abdomen. It was larger than the rest, requiring us to push a thin piece of gauze much deeper than the patient had expected.
Mr. C suddenly reached out, his left hand grasping on air as he hissed through the pain.
“Do you want to hold my hand?” I blurted.
He nodded once, and I grabbed his large, rough hand. Mr. C stiffened and cursed through clenched teeth as the intern apologized.
“Squeeze as hard as you need to,” I said, “I can handle it.”
The intern finished up shortly after, and Mr. C gave me a sheepish smile.
“Thanks.” He murmured.
“You’re welcome.” I smiled back, hoping to reassure him that there was nothing to be embarrassed about.
It was obvious to me that those few seconds of holding Mr. C’s hand had been exactly what was needed to get him through that painful process. Anyone could see that that moment was a very human one and not unusual in the many interactions between healthcare professionals and patients. It was obvious to me that though a spontaneous action, it was the right thing to do for the patient in that moment. What was a little less obvious, though, was what that moment had done for me, not as a medical student, not as a learner, but as a person.
Mr. C was the first patient I saw on my required general surgery clerkship. He was also the first patient I saw after Mom died.
Mom had passed peacefully in her sleep two months prior. She had been diagnosed with metastatic breast cancer some time before and had been steadily declining over the past several months. Her body was weak, her muscles atrophied, her activity limited, but she was still Mom. Her voice was strong, her advice sound, and her faith in God unshakable.
I was in the middle of a week of pediatric overnight shifts when a phone call from my Dad woke me up from sleep. I had just been asleep for an hour after getting home from St. Paul Children’s Hospital.
“Mija,” My dad’s voice was tight and restrained, “You need to come home.”
The following month and a half was a blur. I took time off from school. I wept for hours most days with my father, my brother and my little sister. Some days I only left my room to go to the bathroom and eat. I lost weight, I gained weight, I was raw, I was numb. Some days I played music quietly in my earbuds. Other days the only thing I could hear was my dad’s praying and weeping across the hall.
In the week leading up to starting back on rotations, I spent a lot of time alone in my apartment. Mourning, thinking, reflecting, wondering how I was going to get through the next hour, days, weeks, months, the rest of my life without my mom.
How am I going to be able to talk to patients? How can I possibly counsel them when I’m hurting this badly?
I didn’t suffer nightmares, but I had morbid daydreams that I had completely lost the ability to speak, that I had lost my humanity when I buried Mom. I didn’t feel like myself. Sometimes, I didn’t feel anything at all. Despite the waves of grief, I was eager to go back to the wards, even to just distract myself from my own thoughts.
I remember putting on a brave face for my surgery team, mustering up the enthusiasm required when you first establish yourself in a new rotation. The interns were engaging (more so than I expected from surgeons) and quickly included me in their activities.
On my first day back, my very first patient was Mr. C. While I was not glad to see him hurting, holding his hand was exactly what I needed. I learned that my own suffering did not disqualify me from aiding in easing the suffering of others. My own pain did not mean I was unable to help recognize and be a part of treating it. Despite the raw grief and brokenness that I felt, that brief hand clasp reminded me that I could still help bear another’s pain. I did not have to understand the pain, but I could be present. I did not have to pretend to be a hero, but I could hold a hand.
Altruism alone is not enough to get through long overnight shifts and difficult patient situations. It is not enough to reason through the abject suffering and indiscriminate unfairness of trauma and death I have seen as a student and will continue to see as a future Emergency Medicine physician. In that moment, I learned that being true to myself was just as important as incorporating all that medical school had taught me. I could still be present in a patient’s pain without denying my own. I could be the doctor and the daughter. Dr. Ruelas and Octavia, too.