I said goodbye to my hero for the last time yesterday. We spent the day watching movies just like we used to back before our lives got complicated. She passed today with grace, and she left our world ready. I feel so lucky that she gave me the opportunity to tell her to rest easy, because she of all people deserves to rest easy.
I saw life take everything from her. First everything seemed small; so what if you cannot button up your shirt today? They grew. She lost her home, she lost her independence, she lost her privacy, so on and so forth. I would watch, my heart on the floor, as our world would unrelenting commit some new injustice on one of the least deserving.
I wrote these words the day my mother died. She passed away during my third year of medical school. She battled with multiple sclerosis my whole life. I spent my childhood and young adult life taking care of her. She motivated me to become a doctor. I wanted to have a spiritual reason to work. I would see a patient, who is sick, and accept the challenge of making them better with the thought of, “this is for you, mom” in my mind as I do it.
Sometimes our lives feel prewritten, and we are but mere actors living in a play. The same day I got my Step 1 score back, she was admitted to the hospital I was rotating in eight floors above me. She was no stranger to the hospital, but this admission felt different; this time it felt dire. People remember the moment they get their first boards score back for the rest of their lives. The three numbers on the page represent opportunities gained and opportunities lost. I remember going to the bathroom for privacy as I looked at my score. As I gazed on the screen before me I couldn’t care less. Who cares what score I got when the very reason I worked so hard to get it was dying upstairs?
How do you handle fear? I turn into a leader with one goal, keep your head afloat. Like a man finishing his last song on the violin as the Titanic is sinking, I carry on my duties despite the tragedy that lays before me. My family needed me, but robotically I decided to keep working.
I was visibly distressed. I knew that I would not be able to keep up a facade for very long, so I discussed with my resident that I am dealing with family issues today, and so if she sees me running at half mast that is why. She offered to let me leave. I refused. She did not push, she simply said, “If that makes you feel like you are in control, then okay, but let me know if you change your mind.” I continued to push. Word travels fast. The whole floor I worked on learned of my troubles, and the hospitalization upstairs. The attending approached me. He told me to leave, “Karl, you have more important things to take care of.” The robot broke, the man came out, I teared up. With a quick hug, he ushered me away.
Medicine is a family. I never hear the word coworker anymore. I hear colleague, I hear friend, I hear people talking about their respect of their peers. Despite the family we have great fortune to work with every day, it is easy to feel alone. We do respected work, and share that respect for each other.
The work of a physician is the most professional work one can attend to. That professionalism is important as we deal with patients, who allow themselves to be vulnerable around us. However, somewhere in the professionalism, there is a risk of losing your humanity. To lose your feelings of connectedness. To feel alone. I am writing this as an attestation of the love you go to work with every day. This resident and attending above reached into their humanity and saved me from a life of regret. I was able to lead my family through crisis, like I’ve done so many times in the past. Their embracing of their humanity helped me embrace mine.
They were the first of many. I spent every day’s lunch upstairs with my mom. I would come and say goodbye after every shift. I was implicitly allowed to go and see her and take care of these matters freely from the team. She seemed to be improving. The sepsis that sent her into the hospital gave way, and allowed her consciousness to return. Maybe this incident was nearly over?
I was in a new rotation, an outpatient setting, managing a patient’s diabetes when I got the news. A voicemail on my phone from my aunt. She has two weeks left to live. You know how hard it is to optimize an insulin regimen after hearing this news? I am thankful for the writer of the scripted play I seemed to have found myself in.
The day before I received this news I was talking to one of my mentors. I told her about my experience, the hope I instilled in my family and in my mom. I remember the quietness of her office as she encouraged me to let everyone around me know my situation. She told me to email the clerkship director, just to make sure she is aware of my situation. I did.
When the hammer fell, my clerkship director was ready.
The robot I previously described awoke the day after she passed away. I went to work. An experience similar to the first occurred. This time a resident and a fellow took the honors of forcing me to leave. Maybe the automation inside me knew they would do that. Maybe it knew I needed the validation. The fellow described a death in his life, he described saying to his peer after that death, “Man, I just have so much work to do.” The peer exclaimed, “No, you don’t.” As he left the lab he was working in he felt the clarity of his peers words. Just like the attending above said to me, he was needed elsewhere.
Medical training is hard and long. I am currently on my surgery rotation. While working on writing notes, I overheard the surgeon talking to the second year resident on my team. His words resonated with me. We spend four years in medical school and potentially many more years in residency. That is a lot of time for something bad to happen. Something bad will happen. It shapes who we are as physicians based on how we deal with it. He warned them that their wellness was important. Be there for your family; take the time you need to take care of your loved ones. Without them, who are you? How does choosing to wall off your troubles and work change you? I am not sure of these answers, but it seems intuitive that you’d become cold and burnt out. You place your humanity in jeopardy. I was at risk of losing mine.
I spent as many tears crying over my loss, as I did crying from the profound kindness I witnessed every day. It was less about the content of the emails sent to me, the flowers slowly wilting on my coffee table, or the serene moments people took advantage of to reveal to me that there is just as much love in this world despite this loss. I would encourage you to be a part of this coalition. A beacon of hope for the lost. If you are lost, reach out. I am here, and a big family of people practicing medicine are all around you..
I am interested in neurology. I want to lead people through their illness and provide hope where they think they have none. I want to prepare families in similar situations as mine prepare for the battles ahead of them. It’s depressing, but people with terminal illness need somebody. My mom was my hero. Her motto followed her till the day she died, and now will follow me until mine.
Image credit: self-created art courtesy of the author Nick Gardner.