Prom king

Sahil Sharma is a medical student in the Class of 2020 at Western University

 

It was my first week on service for internal medicine as a third-year clerk. I had finally begun to figure out the labyrinth of charts, forms, and computer apps that went into my interactions with patients. I still had four of the eight pens I’d started with and had managed to misplace my sacred “pocket guide” only twice — so, all in all, I was off to a good start.

I was told by my senior to go see a patient who was in ICU step-down and had recently been transferred to our care. I hurriedly went to the computers and started reading up on the patient’s history.

Mr. C had a long and complicated history. He had initially presented to the hospital with signs of cholecystitis but later developed multiple complications landing him in the ICU. After a flurry of resuscitative measures and close monitoring, Mr. C was finally deemed stable enough to be transferred to the ward.

When I entered the room, I was met with a man who still appeared quite ill. Mr. C had a biliary drain, a nasogastric tube for feeding, and multiple IVs for continued treatment. I didn’t know where to begin. I wanted to inquire more about his medical history, explore his current condition, and run through the flurry of physical exams that I had reviewed prior to entering the room. But given the tumultuous weeks that Mr. C had already been through, it felt unjust to force him to recount those memories.

Instead, I asked, “How are you doing, Mr. C?”

“I’ve been better. Plenty other places I’d rather be than here.”

“Like where?”

That question initiated a 40-minute discussion about Mr. C’s previous travels, interests, and hobbies. Leaving the room, I realized that while I didn’t have much to present during our clinical rounds, I had left with a vastly greater understanding of Mr. C than I would have if I’d stuck to my rehearsed questionnaire of symptomology.

Over the following days, I made a conscious effort to begin every visit with a short discussion about anything other than Mr. C’s current clinical condition. We chatted about his distaste for hospital food, his love of skiing, and his memories about being a college “jock.” We would eventually discuss whether he was in pain, his bowel movements, and his appetite — but it felt less like a conscious extraction of information and more like a friendly check-in. On the days after my post-call days, I would rush to get updates on Mr. C from the prior evening — even though he would be the first to let me know exactly what had transpired while I was gone.

As the days passed, Mr. C started to regain his strength and began to need less medical support. I still remember the days on which we celebrated the removal of his nasogastric tube (and the subsequent complaints about “soft-texture” foods), as well as his multiple IV lines. Under the physiotherapy staff’s diligent supervision, Mr. C slowly began taking a few steps with support. It was clear he was going to need a long course of rehab before returning to his baseline, but we were both ecstatic with the improvements that were made.

It wasn’t until our final day together that I realized how important this relationship had been for both of us. I can vividly recall going to visit Mr. C and being surprised to find him in a full pin-striped suit — I had grown so used to seeing him don a blue hospital gown that I forgot he was once prom king. As we shook hands and said our goodbyes, I couldn’t help but feel both a sense of loss and one of great joy. I knew this would likely be our last interaction, but I had gained so much from our time together.

Mr. C helped me realize that there is so much to the lived experience of every patient; he also enabled me to understand how this plays such an important role in their recovery — as well as how foolish of us it would be to ignore that. It was important for Mr. C to recount the memories of who he was prior to his admission, as it gave him a sense of purpose and a sense of belonging outside of the four walls of our institution. Finally, it helped me to realize that behind all the vital signs, physical exams, and medications lies a unique individual — one who wants to be heard in addition to being treated.

 


Note: The patient in this work is fictitious. Any resemblance to real persons, living or dead, is purely coincidental.

One thought on “Prom king

  1. Robert MacLachlan

    The trigger event at the beginning of this interaction is key, I believe: “it felt unjust to force him to recount those memories.” Without that none of the rest would have happened. Please keep that sense in mind going forward – it is important.

    Reply

Leave a Reply to Robert MacLachlan Cancel reply

Your email address will not be published. Required fields are marked *