76-year-old male, enlarging neck mass
(Final path resulted.)
Path [pathology]: a medical specialty concerned with the examination of bodies and body tissues to confirm diagnoses
I asked him
what he knew
about that lump on his throat.
A feeble smile limped
from one cheek to the other,
stretching the space between his peppered beard,
tugging on the skin around his neck
“Oh you know, I have a feeling
it can’t be good…”
His burly voice trails off,
and resigns before me,
an invitation.
I search for the right words
to write the foreword.
I become an author,
adding chapters and
change his story.
In my silent deliberation,
he thanks me
for making time to talk,
for asking about his daughters,
for saying good morning with a smile.
My gut screams
into my throat,
an instinct
to fight his gratitude.
What work did I do?
What good is this work if
it only brings bad news to you?
A selfish thought hopes
that he already knows.
That the news will not be so unexpected.
That it will not feel so heavy.
In part,
I hope his knowing
will absolve me of
guilt.
As if knowing that a tree is falling
will lessen the pain of the earth it collides with.
I ask him what he knows
about that lump on his throat.
He says he has a feeling
that his mother is calling him home.
This poem is inspired by the first time I shared challenging news with a patient. Before entering his room, I felt unsettled that I knew of his aggressive cancer with a poor prognosis when he did not. During my pre-clinical years, I practiced giving bad news to patients through simulated standardized patient sessions. None of those sessions truly prepared me for the weight of the responsibility I felt entering this patient’s room that day. None of those sessions showed me how heavy it is to feel like you are taking someone’s happiness away. None of those sessions taught me that self-regarding thoughts would find me in this moment.
In the weeks that followed my conversation with this patient, I found it hard to process that this patient’s life changed significantly from before I went into his room to after. It took me several months to view this responsibility and experience as a privilege. In its few short stanzas, this poem walks through my hesitation, denial, guilt, anger, hope and relief and mirrors these changes with the patient’s patience, gratitude and acceptance. Through my third year of medical school, I have seen many moments in which the bustling environment of the hospital forgets the importance of deliberate and thoughtful vocabulary. The words we use as health care providers matter, and they will stay with the patients long after we walk out of their rooms. I am grateful to this patient and experience for beginning to teach me about the art of practicing medicine.
Image credit: “Sunlit fallen tree by the forest lake in winter” by sunsju is licensed under CC BY-NC-ND 2.0.
Medical Student Contributing Writer
Case Western Reserve University School of Medicine
Sriya Donthi completed her Bachelors of History and Philosophy of Medicine and Biology at Case Western Reserve University, where she is now attending medical school. She has been writing poetry since the age of fifteen and enjoys finding ways in which the creative arts and her interest in medicine can connect. Her medical interests are in obstetrics/gynecology and health literacy education.
