Class of 2014
They were blue, the eyes of the first patient that I knew who died. It was a busy night in the emergency room, and also one of my first nights on call as a clinical clerk. I relished having my pager go off, feeling able to handle the problems that were coming my way. Patient with abdominal pain? No problem. I could handle it.
I arrived at the elderly man’s bedside, and immediately realized that he was in distress. As he was unable to answer my questions, I decided an abdominal exam would be the next best step. Crepitus. The word shot through my mind like a dagger.
Feeling my heart quicken, I told the patient that I would be right back. I knew that I needed to get help. He grabbed my arm and whispered, “I’m dying, don’t leave me alone.” The look in his cloudy blue eyes and his firm grasp on my arm made all of the noise in the emergency room melt away. I made a decision: I was not going to let this man die alone. I asked a nurse to page the resident, and stayed by his side.
It took hours before any family was located and even longer for his niece and nephew to make a decision with respect to their uncle’s care. For the first hour, if I so much as shifted a foot farther from his bed, I would end up with a firm grasp on my arm and another order: “don’t leave me alone to die.” Eventually, he became unresponsive, and his grip loosened. I had to leave his room to see other consults that I had been given. When I came back to the hospital the next day, I found out that he had passed away during the night.
That evening, I walked away from the emergency room in a daze. I felt an uncomfortable weight on my chest. I had made a promise to myself, and silently to the patient, that I would not leave him alone to die. I had not been able to keep this promise. The patient had asked one thing of me, the person he viewed as his doctor in the brief period he had been conscious—he did not want to die alone.
But ultimately, he had.
I look back on that experience often and wonder if I should have approached the situation differently. The truth is, I still do not have an answer. Logic tells me that I remained by his bedside for as long as I could have, given the circumstances. My heart, however, perpetually tells me that I failed this patient in the worst possible way: his one dying wish was not fulfilled.
Upon reflection of this incidence, it has become clear to me that the aspiration to solve every problem I encounter is unrealistic. I cannot possibly give myself fully to each patient, as I had tried to with this man, or I risk perpetually experiencing a dreadful weight in my heart.
As a future physician, my role as a healer is continuously being shaped by my experiences navigating the grey area between what is expected of me and what would be considered above and beyond the call of duty. The role of a doctor involves knowing the limits that clinical duties, laws and society impose. What is ambiguous is the extent to which physicians can connect on a deeper level with their patients without causing harm to themselves. There is a discreet implication that a physician must be able to answer the demands of a patient during their time of need. Yet to what extent does this obligation hold true? At what cost?
While these questions may go unanswered, this weathered gentleman and his blue eyes will be a constant reminder to me that I will always have decisions to make, triumphs in treatment and regrets in failure. Variable outcomes are inevitable in medicine, but I believe as long as we are aware of our limitations and how to overcome them, we can continue on a positive path of healing.
This is fiction.