Metaphors & Medicine

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...

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...

  On Palliative Care: Part 1 "There is less doing and more being,” my attending said. Each week in Palliative Care forces me out of what I think I understand, forces me to rethink what I thought I truly comprehended. It sinks in each time differently, deeper, at a level within my soul that leaves me with a feeling that is harder and harder to shake off. When I share that I am doing my clinical apprenticeship in Pediatric Palliative Care, I receive the same reaction: a shocked look, a sucked-in breath, or a hovering question: how is it?  I’ve been adding to this answer more and more as my time in it continues, and I met a patient yesterday that solidified how I feel about it now. While most hear palliative care and think of the word “dying,” I have learned very quickly in this speciality that death is not the worst thing that can happen to someone. I have been in a code before; I have quite literally watched air leave a person, leaving behind the home of the person that inhabit...

“Allah has called you into this. He’s facilitating for you to be in medicine,” my mentor said to me. I was sitting in my car, my mind exhausted from another long study day, listening to the rain dance atop my car. There are very little moments in medicine when we allow ourselves to take moments of silence, to interject the pattern of run, run, run to the next meeting, to the next lecture, to the next item on your to-do list. So while I was taking a moment to listen to the rain, to let it sing calming harmonies into my mind, my phone rang with my mentor's name on it. I just wanted to share the heaviness that medicine felt like these days, how hard it felt each day to just start, so much so that I've taken on a new routine that minimizes the chance for me to think about what I want to do and instead focus on the doing. "Years and years of this, and I'm still figuring out exactly how to do this because sometimes it gets hard," he said. I remember ...

  Dear Self, A year ago, you had hoped I would write, write, write my way through my life until I found myself. You had hoped I would find home, a home that wouldn’t leave me having to choose between here and there. You hoped I would find comfort in my “feel too much and all at once” self. I found that. All of that. I wrote about finding the stories on the walls and OR rooms in Nablus this summer, listening to the living stories through the streets of Ramallah, holding the little kiddo's hand as he woke up looking for his mother, listening to his mother tell me everything that the news did not tell me about the beauty, rather than destruction, of life in Gaza.   My “feel too much” self became my identity, shamelessly, my first and only skin. There was no replacement. I did not fight the stories anymore. My biggest fear has been to lose you. And I abandoned you believing that this was what I had to do to survive like everyone else around me. The truth i...

  I thought the door was closed since we had not started screening patients yet, but when I turned around, I saw a small little human with golden hair smiling up at us. As soon as I saw her, I waved, and her face lit up. Holding her doll in one hand, she slipped away from the door and disappeared. A few seconds later, she popped her head back in, as though playing “peek a boo” with us and thoroughly impressed with herself. I couldn’t help but smile, seeing someone so innocent and unaware of the larger context of what was happening. It was the first day of the mission, the day of screening, where the team screened as many patients as they could. She was one of them, and she was the first patient I met as soon as I set my stuff down in the room to prepare for the day ahead. I had been nervous that morning, unsure of what to expect at a different hospital than the one I volunteered in last, and in a different city. Mostly, I was anxious knowing how the last trip had stuck with me, how...

  I set a goal to be present, to simply be, to find myself in the midst of patient stories in OR’s or packed patient rooms. What I ended up finding was that in the silence of the rest of the world, while I am away from my commitments and all the things I “have” to do, all the people I “have” to be, I am able to hear and feel exactly what I want. The last week that I spent working 8-14 hours a day turned out to be the most life-changing period of my life. There’s something that happens to you when you are away in a different world, and being in that hospital everyday felt that way. The drive into the city each and everyday renewed my intention to serve a place away from my own, to strive to make this new place a home in a way that would make me love its people without knowing them. When you are on your own, you find connections with the people you are experiencing this other world with for they will always be the ones who understand exactly what this experience was like for all of ...

  “They’re arriving in 3 hours. Be ready to meet them and get their story,” the social worker told me. They had waited for weeks to get permission to leave Gaza and come to be seen by the visiting surgeons. They finally got permission two days after the day of screening, but they were coming and that was all that mattered. Three hours later, I received a call declaring their arrival and went looking for a little boy and his mother outside of the OR. As I looked around, a little boy peeked our from behind a woman seated to my right, and smiled the biggest smile, his beautiful big eyes decorated with his long lashes. “ Are you from Gaza?” I asked the woman he was hiding behind. “Yes! " She said. "This is my son.” I sat next to her, reached out my hand to hold his little one, and once again he smiled. Their story was a long one, one laced with medical troubles over his short life and restrictions designed by occupation. But they were here. His surgery was the longest I had ever...

The air is crisp and blows in our faces in preparation for yet another day. Each day brings with it its own share of challenges and often pleasant surprises. I find myself using the hour commute in the morning to reflect and center myself, remember to be present, focus on why I am here, and most importantly, remind myself of all the planning and work that had to be done to embark on this trip, to even have these experiences, to even be sitting in this bumpy commute, driving past mountain, village, settlement, mountain. Each day, I’ve watched the surgeons and anesthesiologist have to become creative and make up for a missing instrument or tool that would normally be readily available in the states. This is no easy job for them, and I call them nothing short of superheroes. They’ve come to Palestine where their resilience in the OR fits in easily with the resilience of the patients and their families. It is a common connection between them, the determination to face the challenges of the...

 “What’s your name, habibi ?” I asked our next little patient. His eyes peered up at me through his eyelashes, and I could tell that he was not shy but rather taking in the moving and bustling figures around him, trying to figure out who to trust. A clever one, and a kind one, with eyes that smiled before his lips did. “ Do you want to have a competition?” I asked. He leaned his head to the side, then nodded slowly. He was seated in a wheelchair waiting for his turn to be out on the OR table. I returned to him with a bottle of water for making bubbles, and immediately became excited. “I want you to blow as hard as you can, okay? Let’s see who can make more bubbles, me or you.” And he blew. Initially, they were small, only one or two bubbles. A few minutes later, he was blowing 10 bubbles or more each time. We all cheered, and his shoulders relaxed, his smile became bigger, and he blew harder each time, and each time was met with our cheers. . Not every problem can be settled like h...

O ne of the dearest humans to me wrote me a letter before I left the U.S., told me to tuck it in my bag and not forget it. “You can only read it on the plane,” she said firmly. I am going to refer to this letter often along this trip because it was exactly what I needed to read upon beginning this journey. So as I am reflecting on my day today and what tomorrow will be, I can’t help but think of a sentence in her letter. She wrote, “This trip is just another line on the fingerprint of your life...except this time it’s a little different. It’s always a little different, and each time it’s a little deeper.” I woke up to the sound of the call for prayer from the mosque’s loud speaker, echoing in the valley of the city. I watched the sunrise in the city this morning, heard the birds greet its residents. I kissed my grandmother’s hand, sipped my grandfather’s mint tea, and kept correcting my uncles as they repeatedly called me and greeted me as “doctor.” I thanked Allah for another visit, a...

“Do you want to be a health and social advocate for your patients?” A local physician asked us during a presentation on racial disparaties and equity.                  My mind began spinning to moments, small snippets which I believe have led to this moment. I recalled my first time working in an inner city hospital while I was a pre-med student. I was working with different physicians in the internal medicine outpatient clinic when a patient arrived who appeared a little disheveled. She appeared happy to see the physician, and immediately began catching him up on where her life was. However, she had missed a few previous appointments, and she began giving a variety of explanations: trouble finding transportation, her son was supposed to bring her but didn’t bring her, she had work and could not leave her shift. The physician was sympathetic and made a light-hearted comment about his happiness that sh...

I watched the young woman across from her wrap the soft stretch of fabric around her face. I watched as she first wrapped it loosely around her head and neck, then undid it and wrapped it a second time a little tighter. She folded a part of it that hung close to her ears and loosened it slightly, put her fingers slowly under the fabric and experimented with how much room there was. Would a stethoscope ear piece fit through each side easily? She unwrapped it again. Put in a pin. Repeated the same finger test. Took the pin out. Tried again. She had chosen a light pink color, in part because pink was her favorite color but also because she wanted something that would make her first patient, even though they were an actor, to feel comfortable with her. The thought of introducing herself to her first patient was intimidating for the obvious reason: it would be the first time she'd take on this role as a student doctor and really try to "fake it till she made it." But most o...