Abstract
M
As I prepared to enter the beast of medical school, I discovered a lump. Three weeks and two surgeries later, I was discharged from the hospital with a giant stamp on my forehead: Cancer patient.
I stood at my white coat ceremony, running my fingers down my tie, my thumb sliding over that 15-inch still-tender scar. I knew what it meant to be sick. “It's devastating! This is horrible!” I thought. How foolish of me to forget that we as providers of health are not immune to disease. I was disgusted with my ignorance. My arrogance!
I thought I had learned the lesson at hand.
Months later, there was more to come. Full relapse. Progression to Stage IV. Refer patient to oncology for further evaluation.
I fell to my knees and sat in the dark. Rocking for hours. “Yes there is a lot of uncertainty. But one thing is for sure. This will be tough. This will be painful. You will suffer. You just have to push through” said my surgeon.
The next few months of chemotherapy were atrocious. I spiraled downward physically.
Emotionally I felt nothing.
Spiritually I was conflicted.
Socially I was withdrawn.
Yet, I smiled and pushed through.
Sure, I knew why I wanted to be a doctor, but I also learned why I didn't want to be a patient.
I carry this trauma on my shoulders daily. I put on my white coat and never forget the patient gown that once lay beneath.
When Delila said she was in pain, I knew what she meant. I felt it: the burning-hot sensation of deep tissue being stretched apart while the staples gnaw away at the remaining flesh. There is nothing worse. Once you have endured this, you can endure it all.
When she endorsed nausea, I understood. The stomach is sacred. It is our body's connection to the outside world. There are few feelings worse than the sensation of undulating yet relentless nausea. Relentless in that vomiting will only yield temporary if any relief. My discussions with patients still leave me nauseated.
When she wanted to be alone, I empathized. I looked at her family and felt sorrow; they just want to help. But this is her struggle and I side with her. This is her battle. She was a warrior, but she knew she had fallen. She wanted to suffer in peace. But a warrior never shows vulnerability. Her family couldn't see her in this state. She caused them enough suffering as it is. She let them be present and suffered internally, instead. True altruism.
Palliative care has reminded me of why I wanted to become a physician. Yes there is disease and disease is bad. What is worse than disease? Suffering. It is my obligation as a physician to bring comfort to a patient. This is irrespective of their choice to treat underlying causes or not. Patients do not remember the disease as often as they remember the symptoms.
Patients with diabetes struggle with compliance because they feel nothing.
Patients with chronic lower back pain are so compliant with their medications because of the pain, creating a concern of addiction.
As a physician, it is my duty to be empathetic, compassionate, and knowledgeable when it comes to the patient. I have been reminded that the rest is as the patient wishes…