When I walk down the halls of the hospital wards, white coat and stethoscope in hand, I feel at peace. I am finally where I dreamt I would be. I spend my days in the hospital helping out residents, checking in on my patients, writing progress notes and preparing presentations for the attendings on service. Even on my worst days, I leave knowing that I helped people in some way. That feeling persists even after I get home, hang up my white coat and change out of my scrubs. It is when I am lying on my couch, watching TV and trying to relax that I am reminded that I have a chronic health condition.
I have ulcerative colitis (UC), which ranges from mild to incredibly severe depending on the day. With proper treatment, diet and exercise, UC is a controlled disease. During times of stress, however, it tends to creep into my daily life making even the simplest of tasks mountains to overcome. Before I got a proper diagnosis I had symptoms that would rarely affect my daily life; therefore, I rarely thought much about it. That all changed during my first year of medical school. I had a severe case of bacterial gastroenteritis which later progressed to sepsis during my hospitalization. Thankfully, I fully recovered from the infection within two weeks of discharge and was able to pick up right where I left off in medical school. During the following month afterwards, however, my symptoms became uncontrolled again and made simple life activities very difficult. It has taken years of doctor appointments, medications and lifestyle adjustments to get my symptoms under control. Inflammatory bowel diseases often become unmanageable after a severe bowel infection, as in my case. I went from an adult with an occasional headache to someone battling a chronic gastrointestinal illness in what seemed like overnight. My situation worsened when I noticed some non-specific symptoms including fatigue, muscle weakness, weight gain, impaired concentration and stretch marks.
“Could this be Cushing’s disease? No way, that is way too rare,” I thought. I ignored the symptoms and told myself I was experiencing what my professors term “second year syndrome.” At this point I had heard enough stories of medical students imagining they had a variety of diseases they studied; I did not want to be another one of those students. It was not just embarrassment that kept me from seeking help. I was afraid of having another illness. However, a nagging feeling that something was not right pushed me to make an appointment with an endocrinologist. Before I knew it, my lab work came back abnormal raising suspicion for a pituitary gland pathology. I was promptly scheduled for brain imaging. While pituitary adenomas are not cancerous, they are actually quite deadly over time due to excessive cortisol. The anxiety and fear I experienced knowing that I might have a tumor growing inside my brain were beyond words. I had become intimately aware of the symptoms I once studied in my preclinical years: the tumor could cause a blood clot which might turn into a stroke, press on my optic nerves leading to blindness, increase my risk for a heart attack and the list goes on.
I was never a patient before I was a doctor in training. Now I was being wheeled down the halls to my hospital room after I had been the one pushing the gurney for others. I was handing people their hospital gowns and attaching them to the monitors before, but now I was the one wearing them. I was comforting my patients, and now I was the one seeking it. So often patients bare their souls and leave their health in the hands of their medical team. Truthfully, I had taken that for granted. I had no idea the vulnerability it took to allow people to take care of me and trust them when they said I would be okay. Going forward, when I do any of these things for my patients I will do so as someone who has lived both roles.
Dealing with a chronic illness during medical training has been as enlightening as it is burdensome. Thankfully, my evaluation for a pituitary adenoma was unremarkable but the frustration and anxiety I felt during that time were but a mere glimpse of what the patients passing me in the hall carry every day. I began writing this piece to help me cope with everything that was going through my head, and when reflecting on it three months later, I am grateful for the peace I now feel. The trust between a medical provider and a patient is not to be taken lightly, something I experienced on both ends. I often think of this while doing something as simple as removing an abdominal drain for my patient or laying in a hospital bed in pre-operative area before another colonoscopy.
While my disease is in remission and has been for almost a year now, I have not forgotten how I leaned on the people taking care of me when I required help. I deeply resonate with the phrase “to understand someone you must walk a mile in their shoes.” I believe the obstacles that I have overcome allow me to truly confront what it means to be a patient. My experiences as a patient have forever changed how I will practice medicine. I have finally reached the point where I am grateful for that.