This story is shared with permission from a young man who is dedicated to becoming the finest physician, giving up most of his 20's to pursue the educational requirements set forth for doctors. I hope you are as impressed with his heart for patients as I am. I am so privileged to work with such motivated learners day after day.
"I spent the first nine months of my third year of medical school sifting through the many specialties that medicine has to offer. My stress level continued to build after each rotation passed, not knowing how I would spend the rest of my life. I had spent the previous two years buried in textbooks, learning everything I could that would prepare me to be a great physician. While the nights spent studying seemed endless and social lives took a backseat, I felt a certain satisfaction in building my knowledge base, knowing how this would affect my future as a physician. However, I was continuously discouraged as I worked through my rotations, finding I wasn’t quite satisfied with just knowing the science behind my patients. There was something I needed in a career, but I didn’t quite know what that something was. It wasn’t until I met a homeless, elderly gentleman a few weeks into my internal medicine rotation that I found that something.
As I entered the ER bay, I was greeted by a man in excruciating pain who appeared deathly ill. Upon questioning, he revealed he had been living in a run-down hotel room for months since his house had flooded. He revealed his extensive history of cocaine and alcohol abuse. The patient was admitted to the ICU, spending over two weeks in the unit recovering from multi-drug resistant Streptococcus pneumoniae pneumonia. I spent every morning during those two weeks checking on him, getting to know him as a person, not just a chart number. There were mornings he was not particularly pleased to see me. Compounded with the frustration of spending an extended period in the hospital, he did not necessarily greet the team with a smile every morning. One particular moment, however, will stay with me forever to remind me why I chose to go into medicine in the first place. Before discharge, the team visited one last time to discuss follow-up and discharge medications. My attending spoke honestly with him, “Patients in the condition you were in when you came in probably walk out of the hospital about twenty percent of the time.” Those words broke through the facade. Tears streamed down the brash old man’s rough face. He thanked us over and over, making it clear that he appreciated the care rendered and had only begun to understand the severity of his situation.
This personal interaction with patients is what I had been seeking in a career all along. The complexities of the physiology and pathology encountered daily are certainly attractive to me when deciding how I want to spend my workdays. However, treating the whole person necessitates considering many variables for each patient and this is what makes internal medicine so special and what attracted me to pursue IM residency training. Patients have different layers and complexities. Treating a patient with pneumococcal pneumonia is one thing. Factoring in the patient’s social situation, history of substance abuse, and whatever else a patient may be experiencing changes the game. There are great guidelines backed by fantastic scientific evidence that can teach us how to operate on a patient or treat a patient medically. It is what is not taught in the textbooks that I find is particularly important in internal medicine. It is for these reasons that I know that my days spent practicing will not be monotonous, as I will constantly learn from my patients and peers until the day comes that I am unable to practice medicine.
Throughout my residency and clinical practice, I will integrate my clinical knowledge with my ability to build relationships with my patients. I will continue to study textbooks and literature finding answers to treat my patients’ diseases. Treating the whole patient, however, requires building relationships and rapport without biases or unwarranted judgment. I look forward to this period of broadening my medical knowledge and patient interactions."
Fourth Year Medical Student