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Metaphors and Medicine (Year IV): Chapter 2

It is early, as it usually is when I walk in to listen to the little hearts and lungs, measure the harmonies of their breathing, and watch the redness return to the tips of their fingers when I let go. Sometimes parents stir, and you get to be the first face they see in the morning before they search for that of their child’s. Did their lungs sound okay? Are they breathing okay? Is it going to be an okay day today? But the experience becomes different when that early morning visit is to deliver news of the bubble of uncertainty they are currently residing in. To watch a parent’s face fall apart as they are told the big “C” word as attendings try to make promises to find answers, to provide them with some answers that will be their solace in comparison to this uncertainty. They probably will not remember this conversation as much as they may remember that single sentence. There is a consistent pattern when they hear it. I can see their mind working to process, at an astronomical rate, a...
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Metaphors and Medicine (Year IV): Chapter 1

 “The truth is...no one wants to have a pediatric oncologist walk into their room,” my attending said.  But there we were, seated across from the patient, at eye level, confirming her own suspicions. Cancer , he said. She had read about it on google but hoped like the rest of us that her thoughts were just due to being engulfed on the internet for far too long.  Cancer , he said. He said the word. But she put a story to it. She had a a dream job that she was working every day for. She had younger siblings who looked up to her. She was a daughter, and her mother had seen her own fair share of life’s betrayals. And now, she was watching life betray her with her daughter.  Cancer , but really it’s a weird feeling to know one’s body has done things out of its control. Suddenly the body’s pain needs control. The body’s nausea needs control. The body’s aches need control. Suddenly, the body one did not think too hard about needs an extreme amount of attention, and we check...

Metaphors and Medicine (Year III): Chapter 3

I could hear the engines of the aircraft blaring below me, the soft rumbling moving our chairs beneath us. This part was always my favorite, the excitement of looking out the window and realizing the next time I’d be on the ground again, the view outside the window would be one that always made me feel whole, alive again, and the closest to myself that I ever felt. It would be the beginning of weeks I would never forget, as my time back home always is. It didn’t matter that we stood in line with so many people. It didn’t matter how heavy the suitcases were. It didn’t matter that it would take hours of passing through Israeli border control before I’d finally say “I’m home.”  What mattered is I would be home, once again, for a brief period that would leave me in a state of grief once I left it again, trying to hold myself together until the next time I was aboard that plane. This was one year ago.  Two years ago on this exact day, I was finishing my final day on another pediatr...

Metaphors and Medicine (Year III): Chapter 2

Knock.  Sanitize .  Introduce yourself.  Excuse yourself for interrupting their breakfast.  Find a seat if possible to sit at their level, to speak to them, rather than speak down at them.  Hope they’re feeling better.  Hear their progress and celebrate even the little milestones.  Let them vent their complaints, their worries, their misfortune to have this happen to them.  Listen to their heart. Listen to their heart. Listen to their heart.  Make a plan. Walk more.  We want you walking more.  Encourage them to stick to it.  Hold them accountable by reminding them you’ll be back to hear about more progress, to cheer on their progress.  We want you better.  We want to help you be better, feel better, look better, sleep better.  Go around, see more patients, repeat repeat repeat.  Finish note.  Write the next one.  Sign sign sign.  Hope you didn’t forget anything.  Take a sip of liquid...

Metaphors and Medicine (Year III): Chapter 1

“Even though you leave the hospital doesn’t mean the hospital leaves you.”  I have heard this countless times over the last few months in particular as I have ventured through clinicals. We get talked to about work-life balance, about the need to create a safe space for you to escape to without the weight of the lives on your shoulders. Yet, surgeons said they woke up at night wondering if their patients had complications overnight, pediatricians saw their young patients in their own children when they put them to bed at night, hospitalists rechecked if they had put in the correct medication order hours prior to prevent any terrifying adverse outcome.  Yet this *pandemic* that I am so tired of reading/hearing/living/breathing/speaking about has made me think more and more about what that must feel like.  I think often of the patients I had during my month on Transplant Surgery and wonder if their immunocompromised states have survived what we have all been afraid ...

Metaphors and Medicine (Year II): Chapter 5

On Palliative Care: Part 3 She had been at school, doing what she did every day. She probably said “see you later,” to her parents. Maybe she had plans with friends after school, a test to study for, another college application to submit. But instead of doing those things, she was struck by a vehicle that landed her on our floor looking very different from the girl whose smiles was now all over the walls of her room. I noticed her nails were painted a dark shade of blue, and I remember thinking how such a little simple thing reminds you of a life that each patient, each person, lives outside of these four walls. And then something happens, and they land here. They are here, and it’s up to us to keep their story as alive as possible, no matter how many machines they are hooked up to, no matter how many terrible imaging and lab results they receive. There’s a story in each room. After my first day in Palliative, I recall telling my mom how I felt as though my “emotions finally had a home...

Metaphors and Medicine (Year II): Chapter 4

On Palliative Care: Part 2 My attending tended to Mom, listened to her. It changed the meaning of “comforting someone.” Palliative is less doing and more being. He was present with her, and said less, did less. Stood, listened, tilted his head in a way to show her he was listening. She pulled her phone out and showed him a video of her daughter singing. She was beautiful, I thought. But then again, who wasn’t? . We walked into her room, and my eyes were drawn to the four walls around us. There was her story thrown all across the walls in the form of photos of her with her friends and family, cards with written notes inside of them, posters from the teams she was on. There was her story, and you could read it wall by wall. Finally, my eyes rested on the center of the room where she was lying very differently than in her photos or video. Up until this week, I had seen children with complex histories of chronic illness and developmental issues. They and their parents had accepted their l...