University of Toronto
Class of 2019
His voice is warm and soft, each sentence running into the next, broken up only by gravelly laughter and the occasional cough. The honey that coats his voice obscures his jarring story, the suffering hidden beneath the evenness of his tone. He tells me about his injury, rating his pain on a scale of one to ten, and describes its quality and radiation. I ask him for his previous medical diagnoses and he pauses briefly.
His pause is an active addition of space into the conversation. A rebellion against my laundry list of questions forcing organization onto an interview that was begging for release from the confines of my tabular template. He says that he was raped as a young teenager, and explains the effects on his physical and mental health that persist decades later. My mouth is dry. I hear myself choke out an apology, the word “sorry” hanging in the air, sounding contrived and insincere. I pause, but it is a passive response, representing my retreat from the conversation due to the fear I felt in the face of a profound lack of agency.
As a medical student, I spend days mulling over neuroanatomical minutiae and pharmacokinetic interactions, thinking that the knowledge base that I am building will allow me to better diagnose and treat my future patients. With this patient, however, I was confronted with the harsh reality of the powerlessness of medicine. Despite vast expansion of the body of human knowledge, medicine is still bound by limits of humanity. There are incurable illnesses, unalterable pasts and unavoidable suffering. It is in these terrifying realities, however, that we bear witness to the power of the human spirit.
Despite my withdrawal from the conversation, my patient continued to tell me his story. He calmly described the way that systemic forces have pushed him into illness. He told me about the pain of oppression, the kind that cannot be quantified on a scale of one to ten, radiating throughout one’s entire being, simultaneously sharp and throbbing. It became clear that the voice that had seemed so disconnected from his story was a display of his incredible strength in not allowing his circumstances to define him. Instead, his words ooze sweet warmth, a continual reminder that he is an artist, a friend and a family member, rather than simply his list of chronic illnesses.
My patient reminded me that the failure of scientific medicine is an opportunity to exercise the humanistic side. We can acknowledge the strength of our patients, ease their suffering, and allow them to pursue activities that add meaning to their lives, even if we cannot provide a cure. We can fight to end oppressive practices and to destroy the societal workings that keep our patients in cycles of illness. We can provide empathy and honesty. We can define patients by more than their pain.
I pause again, actively this time, allowing him to finish his story, before thanking him. His voice will stay with me, a honey-coated reminder of the limits of medicine and the power of humanity.