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Metaphors and Medicine (Year 1): Chapter 5

The lights were shining into my eyes as I scanned the crowd. To my left and right stood my classmates, my future colleagues, maybe those who would be my friends.

 The light remained in my eyes as I tried to find the people who I wanted to see the most, the ones who helped me make it up onto this stage, whose support carried me through each obstacle and barrier that stood between myself and this moment.

"Manar Mohammad," the announcer called. I pulled my arms back to make it easier for the physician standing behind me to slip the crisp, white sleeves over my arms. He draped it over my shoulders, straightened the back, and let it go. The white coat slid comfortably onto my upper body and bared its weight onto my shoulders. I felt goosebumps go down my spine as I realized that this weight would change as the years went on. In this moment, it was as light as a feather, allowing me to fly onto cloud 9 and be so completely content in this moment.


"So what do you think?" Our attending asked, 3 months and 1 week after that serene moment. "Is your white coat a cape...or is it a shield?"

Months ago while I was a scribe in the Emergency Department, I watched a machine (called an Autopulse) compress and decompress someone's chest during CPR, pumping and pumping life back into them. Their body moved up and down on the table, and it was one of the most painful moments to watch. The family was brought in to see for themselves the measures that are taken to keep someone alive, the pain it takes to keep someone alive.

That was all that had to be done for the pain to stop.

The machine was stopped. As the tubes and machines were stripped away, slowly their loved one looked like themselves again. A sleeping version of themselves but still one they recognized. They held their hand. They caressed their skin. They searched for the familiar pearls of this person they loved, asked to hear their voice, asked to see their gaze again.

In that moment, I searched for the ED attending I was working with, who had resumed working on another patient after taking some time with this family. He resumed his role. He was functioning.

I believed the white coat to be a cape, compelling everyone around you to believe in your superpowers, to give you the room, to trust your presence. However, in this moment, I prayed to God that the white coat would be a shield if I needed it to be.

A struggle I will always face is the process of learning to define the line between "caring enough" and "caring too much." However, as I have learned in a mere 3 months, I do not believe there is a way to care too much.

Yesterday, the attending I worked with allowed us to sit with a patient and their family. We listened to the story of how difficult it was to see the body compressing and decompressing, attempting to pull life back into them, desperately dragging life back into them. And a part of me was worried I would "care too much." But could we ever care too much?

My white coat hugged my shoulders, protected my heart, caressed my shaking hands.

I was not ill. No matter how much a patient or their family told me, no matter how much I hurt for them, I was no ill. I did not have a family member in their shoes. I was going to leave and take off the white coat, and at some point I would be able to resume my routine. That's just how life works.

I have been at a point where someone's story struck me so much that I couldn't resume my routine immediately, which is what brought me face to face with this "you care too much" battle. So I began to arm myself to draw a line between myself and a patient because I couldn't lose functionality. However, feeling this pain for a few moments is important. It's vital to understand life's fragility, to understand the weight of the white coat, to understand the trust that I will one day have to carry around with me.

There is no way to care too much because at some point, after their story carves a memory into my life, perhaps even changes me in some ways, I will have grown, but I will not be them. So there is no way to care too much.

Perhaps we walk into a patient's room and tell ourselves our white coats are our capes. However, at some point, they could become shields, guarding ourselves from getting too drawn into a story that is painful to picture ourselves in. If we let down the shield for a second, and let ourselves truly believe it was a cape, then perhaps we'd believe in our ability to grow stronger from every moment of vulnerability, every mistake, every tear that fell from a patient or their loved ones eyes.

I do not believe there is a way to care too much.

The white coat will not remain light. As I learn more and more about myself, the weight of it on my shoulders grows heavier, bringing me face to face with the reality of the responsibility I am gaining with each day I learn new skills.

The conversation with our attending was a challenging one, but I felt so overwhelmed with the fact that I was here. You see, maybe you are like me. You do not feel the best at physiology or biochemistry. You are still learning the best way to navigate through your classes and make it out alive. Not many students feel comfortable showing that vulnerable side and being honest about their struggle.

Well, here is mine: I am a writer. I am a storyteller. I fell in love with medicine because of my love for stories. And the key about storytelling is that you have to feel. I have written poems in perspectives of people I do not know and have cried while reading them, believing for those 2.5 minutes that I was them. I believe that storytelling bridges gaps between people who thought they had nothing in common. And yet, the compassion and connection they may feel from sharing their stories ends up bringing them together. And now as students, we are all playing a role in each other's stories. In this one day where I let my guard down and focused on the stories in medicine and not just the physiology, I was reminded of why I am here and what skills I bring to the medical field. Search yourself and ask what skills you have. Embrace your weaknesses; we all have them. But then find a way to highlight your strengths. Mine are best expressed in these words, in these lines.

The heavier the coat grows, the stronger I become to lift my shoulders under its weight. And in the moments I feel I am unable to keep myself up under its weight, I think back to that moment on stage when I scanned through the lights and saw the faces of my loved ones reminding me that in the past, other moments felt just as hard. The challenges change, they become harder than before, but you also become better than you were before.

The coat will become less crisp with time, but I will grow into it, and it will slowly fit much better.


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