I walked into Mr. Jones’ room tired, frustrated, and exhausted. We had been in the hospital for fifteen hours. A surgical case went awry in the OR, forcing the cancellation of our other cases in the afternoon. The attending called for teaching rounds at 5:30 PM on a Friday night, and I managed to get every single question he asked wrong. We hadn’t eaten lunch. Everyone was irritable and sleep-deprived. I looked down at my cell phone to see some invitations to dinner. “FML,” I tapped out to my roommate. Fuck. My. Life.
Mr. Jones was sitting upright, and he leaned back into the bed when he saw me come in. We went through the same routine we’ve had in the last few days; we talk about his afternoon, his pain, any nausea?
In reality, I was just making small talk—I was trying to work myself up to give him the news. We had gotten to know each other so well in the past few days; Mr. Jones was 31, roughly my age, and a talkative character from West Africa. We had clicked immediately when he was admitted. He was diagnosed with intussusception, a rare condition that occurs when the colon telescopes into itself, causing bleeding and pain. In adults, it’s almost always associated with some type of mass, and the fear was cancer. He had four kids. I broke the small talk.
“Well, I’m here because your pathology report came back.” I paused without thinking, not for dramatic effect, but simply because I saw his eyes widen. “It’s not cancer.”
He breathed the same sigh of relief that I had when I viewed the report only ten minutes earlier. I told him what the report meant, and how although we don’t know what caused his condition, he doesn’t require any more treatment. Mr. Jones shook his head. I smiled. This was a happy moment.
Suddenly, he grabbed my hand. “Thank you so much.” And as suddenly, his speech turned into prayer. “Please God, take care of this man, for he has cared for me like a brother, and give him the strength and will to succeed during these difficult times.”
What he said was simple, but I suddenly found myself tearing up as he continued with the prayer. The pathology report was beautiful news at the end of an awful day, but I was extraordinarily tired and I found the sudden encouragement overwhelming. He looked up from the prayer. “It’s okay to cry, “ he said, in a sudden reversal of roles.
I struggle now to explain why this moment was so emotional. There was, of course, the matter of the path report. And, I had been exhausted and humiliated during the rest of the day, and to hear someone articulate support when I felt so beaten down let loose a floodgate of emotions. In many ways it was a recognition of fear, concerns that I was doing badly, and the realization that perhaps I’m not made for this work, that I’m not tough enough to tolerate the sleep deprivation, and that I’m not tough enough for medicine.
This was further confounded by the fact that I didn’t feel like I deserved his thanks in any way. He was so extraordinarily thankful, but in reality, my role as a medical student was very limited in his care. He has his surgeon to thank, as well as the chief resident, who made all of his major medical decisions. The medical student doesn’t even have the authority to write orders. Granted, we act as ambassadors from the surgical team, and we offer a face and conversation to help patients navigate their time in the hospital, but the reality was that if I was deleted from history, Mr. Jones would still have received his surgery and treatment, and his outcome would be no different.
I felt like a fraud, and I found that I could take little pleasure from his thanks. The most upsetting aspect of the day, however, was that the only lesson was that there is no lesson. Did this moment make having only four hours of sleep worthwhile? Why was I struggling so much to understand what was happening to me? How have I found myself suddenly standing at the bedside of a patient, talking softly but launching echoes of life?
