Another day at the office.
Snooze on the alarm clock as many times as you possibly can. Quick shower. Get dressed. Lace up the oxfords. Burn your tongue on cheap coffee. Fix your tie in the car mirror before walking in.
Another day at the office.
Say good morning to the staff. Make small talk with the attending physician. See some patients. Present them. Get asked, “well what do you think? What should we do?” Trepidly reply. Get it wrong. Feel stupid. Get the next one right. Feel smart. Here’s your cookie for the day.
Another day at the office.
Patient after patient. Well check. Med follow up. Ice and ibuprofen. Antibiotics. You’re fine. Refer to ortho. A day in the family med office. A fine-tuned machine with the health care tyrant’s corporate logo plastered on every wall, white coat, and welcome mat. The TVs in the waiting room no longer play the news; rather a 30-second loop of stale advertising from our overlords.
Lunch time is approaching. See patient in room three. Do the little half-hearted “doctor knock” on the door as you’re opening it. Goooood morning, I’m Jsoze and I’m a third year medical student. I’m just going to ask you a few questions and do a quick exam then we’ll get the real expert in here. Chuckle chuckle. What brings you in today?
She was in her late twenties. I think. Maybe thirty. She was dressed in fashionable clothing. Diamond ring on the left fourth digit. Though well put together, she appeared to have malaise. Perhaps she was ill. She said, I am depressed.
Then tears welled up in her eyes.
Oh no. There’s no Anki card for this situation. I am just a stupid third year medical student in the first week of my first clinical rotation. I spent last year as a cave-dwelling machine of studying excellence devoid of healthy human emotion. They didn’t prepare me for this.
She put her face into her hands and started crying.
I awkardly scooted my chair closer. Grabbed a box of tissues and put my hand on her shoulder. Can you tell me what’s wrong? What’s been going on?
“My husband. He has been distant. I feel that he does not love me any more”.
Now, I’ve been in a relationship or two. I’ve given advice to friends who have gone through break ups. But I am not a marriage counselor. This isn’t my forte. Where do I fit into this equation. Why am I worthy of being trusted with a stranger’s deepest fears. Do I say – sorry, let me grab my attending doctor. He can prescribe you some SSRIs or refer you to a fine psychiatrist or therapist or something. I don’t know. I’m new here. She continued to cry.
Left brain says run through SIG E CAPS. Right brain says give her a hug.
Can’t do that. I don’t know what to do. I’m new here. I fumble with working up the most common conditions. This is surely beyond my scope. But I am human. And maybe she doesn’t need a doctor at this very moment. Maybe she just needs a human. I asked her to tell me her story.
She moved to town a few years ago with her husband. She is from Iran. If I remember correctly. He moved here for a job that I don’t remember. She was working two jobs, neither of which I remember. Little details don’t get processed. The face of hopelessness does. I explored further. Why do you feel this way?
She momentarily paused her sobbing, raised her head from her hands and exposed her bloodshot eyes with mascara-stained raindrops spilling down her cheeks and she said, “I cannot give my husband a child”. We held eye contact for a few seconds before she returned to her face to her hands to cry again.
I grabbed more tissues and returned my hand to her shoulder in attempt comfort her in the most non-awkward way possible. I asked the obvious questions. She and her husband had been trying to conceive for years. It hadn’t happened. They saw reproductive specialists. They had tried everything and explored every avenue. All roads read – No Outlet.
I know nothing about the intricacies of trying to get pregnant so I could not investigate that topic any further. I asked her about support. We all need somebody to lean on. Bill Withers said that. Do you have friends nearby?
She had a few fringe friends from work. They’d meet up for coffee once in a while. They weren’t close.
What about family, do you have any family around? Or anyone you can call to talk to?
The majority of her family lived overseas. They didn’t understand. She felt that to them, and to her husband, her job in life was to produce a child. And she couldn’t. To them, she was a worthless failure of a wife. And even if that weren’t the case – that was how she felt. That is what she said to me.
My heart hit the floor. But as much as I can try, I can’t understand. I don’t know what it’s like. I felt sad for her. But I don’t know a fraction of the despair, worthlessness, and alienation that she must feel. The poor woman sitting in front of me was sobbing, lost, and alone. Medical school preaches empathy and compassion and all that. Over the first two years they spent hours in lectures and seminars trying to teach it to us. But all of that time is meaningless until you actually confront it. When you’re in a room with an unfamiliar human being pouring their heart out to you like you’re best friends sharing two bottles of merlot on a rainy Saturday night, you either feel something or you don’t. This should be a part of the curriculum.
A whole lot of pain she was holding back. A secret that she had no one to tell about. A chained weight around her ankle that she had to drag with her everywhere in secrecy. So far from home.
I felt her sorrow. And I felt that there was nothing I could say. I was searching for a glimmer of sunlight to crack through the black clouds. And I just couldn’t find it. But when there was seemingly no hope, and I was reaching the point where I realized I had to abort the mission and defer to the attending, we found that glimmer of sunlight.
Between taking deep breaths in attempt to collect herself, she muttered, “I do have my dogs”.
“Yeah?” I looked at her with an expression that said, go on – tell me more.
She had four dogs. Two black labs. I don’t remember what the other two were. I asked her to tell me more about them. She told me their names. Where they came from. Which one liked to jump on the table and steal her food. Which ones were the best cuddlers. She started to become lively. Cheerful, even. We were gaining momentum. Tears dried. Her eyes brightened. And I saw the first glimpse of a smile. I persistently asked her to tell me more and more about her pups, because they made her happy. I could feel how much joy they brought to her.
Before you know it, ten minutes had gone by that we’d been talking about her dogs. She was showing me pictures and videos of them on her phone. She was smiling. I’d point one out and say, this looks like the ornery one. She laughed.
Pausing for a moment, she looked at me with sincerity and said, “without them, I don’t think I would be here”.
I told her that when she goes home she better walk in that door and give those cuties some extra lovin and all the cuddles they could ask for. I think this is where the story ends. We eventually concluded our moment. Even if it were just a small victory, I think she left in better shape than she was when she walked in. I presented her to the attending. With his guidance, she agreed to give counseling a try. As well as a visit to a psychiatric professional who could help her. I hope they did. I have no idea where that woman is now, but damn do I wish her the best. I hope she has found peace, or is in the process of doing so.
My family med rotation has been over for nearly two months, but that is the one patient that stuck with me during my time there. That was the most interesting case I saw. Because I learned the most valuable lesson of my fledgling medical career…
Dogs, man. Dogs are the answer. I don’t even know what the question is, but dogs are most certainly the answer. When I’m an attending, no matter what the problem is (shut-up allergies), I will certainly prescribe “Two hours a day with a good boy of your choosing PRN” along with every medication. Our nation’s elite medical schools should immediately allocate research funds into the medical benefits of pups. Every hospital staffed with a trained team of good boys to save the day when modern medicine fails.
Because dogs have some super serious healing powers. They saved that woman’s life. In our universe, no matter how much may be apparently wrong, at least we have dogs. Friggin dogs. Good boys. Fluffly little domesticated stuffed animals that live and breathe to love. They greet you at the door and shower you with fuzzy affection on your best days and on your worst. All they ask for in return is a little piece of your dinner, a good fetch session, some petting, and a brisk walk. And they give you true, unconditional love.
Hope you enjoyed this post because this is the kind of thing I truly enjoy writing about. I have a few last Step 1 posts that are all nearly finished so hopefully I’ll just release them all in the next week or so. To stay updated or ask me any questions, follow me on Twitter: @JordanSoze