The new academic year was approaching at the time of my encounter with Mrs. Doe. She was a professor at one of the local medical schools in town and was gearing up to teach the incoming, wide-eyed first-year medical students, as she had put it. She came into the clinic that Thursday morning to see her neurologist so that he could adjust the settings of her deep brain stimulators that were firmly planted within her brain. She mentioned wanting to start the new academic year on a good foot, hoping to keep her tremor at bay.
She suffered from what is known as an essential tremor, and it predominantly affected the muscles around her head and neck. She had been living with her tremor for years before she finally decided to take a major step toward a life with the potential of tranquility. Her head shook from side to side as she looked at me sitting directly across from her. She had this keen look that expressed a sense of wonder and curiosity in her eyes. I could only imagine what she was thinking when she saw me introduce and position myself in front of her. This was the first time we were meeting, as I was the new third-year medical student on the neurology unit. I was most likely yet another new face in the same short white coat that she had seen in each of her encounters with her neurologist. It was a teaching hospital where new students rotated through every month. Yet, that somehow did not make this initial encounter any more comfortable. Having to see her physician every few months with a new stranger in that pristinely-white short coat had to have taken its toll. What was a unique experience for me was what she had been through at least a dozen times by now. It was her new norm in the wake of her tremor. The very acknowledgment of this perplexity and knowing of my own invasive presence made me even more aware of the coat I dawned.
During the visit, the neurologist utilized his tablet to adjust the various settings of the deep brain stimulators while keeping a careful eye on Mrs. Doe’s head to evaluate how each variable affected her movement. I, too, stared at her head, trying to focus on her forehead rather than her eyes to make the staring less uncomfortable for the both of us. I watched as she moved her gaze from me to the doctor and back to me. It almost looked as if she was watching a ceaseless tennis match, as she hoped to finally feel her tremor subside.
This would go on for about twenty more minutes as the physician explained his changes to both of us. He would alternate between using layman terms for our patient and medical jargon for myself as he sought to teach me a little about how the device worked. He adjusted the depth, frequency and range bilaterally, basing each adjustment on the magnitude of her tremor. In the end, we were able to reduce her tremor significantly, and she thanked us. After the procedure, we sat there for a few more minutes talking about medical school admissions and what each of our experiences was like going through the process, each having a different perspective on the topic. We gradually ended the encounter, and the physician and I were off to the next patient.
After this visit, I found myself fascinated by the juxtaposition I had just experienced. We had gone from new acquaintances to a provider-patient duo, with her ailment on full display for us to treat as the providers. Then, just as quickly, we were back to three individuals making small talk as if conversing over coffee. At that moment, I realized the power of the short white coat I had dawned as I walked into those small 10’ by 10’ rooms. It was like a key to someone’s most vulnerable state. A key that could pierce through the façade that we all put on as a defense mechanism. It made me all the more aware of just how powerful that short coat was in my educational progression.
Within this line of work, we often see patients at some of the most vulnerable times of their lives. We see patients when they are learning of a new life-altering diagnosis, when they are bringing their most prized possessions into this world and when their life, quite frankly, hangs within another’s hands. This encounter was no different. There was no escaping it. Yet as much as it felt invasive, it also felt welcomed.
The privilege to serve and to be trusted with another’s dignity is a weight we all, as medical providers, willingly pick up when we enter a patient’s room. As I tread forward through my third-year rotations, this privilege is one that I must take the time to appreciate with reflection. My patients’ stories better build my own and give their ailment an additional avenue to make a difference in this world, as a guiding hand to a young student’s wandering shoulder. Therefore, I reflect, desperately trying to make sense of my observations along the way, hoping that they may one day make me that much better of a doctor, a leader and a listener. As my white coat grows longer, I hope my observations can slowly mold me into an individual worthy of another’s vulnerability.