“Is this it?”
I sat back surprised as I stared down at my phone, the screen blinking back up at me as if also caught off guard. It had only been a few months since my graduation and I was faced with my first big case – my grandmother was dying and my older cousins started to ask me if she was going to be okay. Even after countless hours of practice on the hospital floors, I never once thought I’d be “breaking the bad news” to my own family. My voice caught in my throat, my hands pausing over the keyboard as I tried to figure out what to say.
What was probably only seconds, felt like years and imposter syndrome began to kick in. How would I tell them that her vital signs didn’t look good? How do I say that the rattling breath they were beginning to hear was a sign of the end drawing nearer? How would I describe to them how quickly death’s embrace would come and how no matter how ready we were for it, it would still catch us unaware?
After countless hours in lectures, clinical simulations, laboratories, and on duty, I forgot to consider this side of medicine. We talk so much about the professional – how we present cases, how to do well in conferences, how to speak in rounds or answer questions posed to us by our attendings, and yet I forgot sometimes that for many of us, the questions that will be asked of us are not the ones being asked by our patients, but of our own family members.
For many of us, medicine isn’t just in the fluorescent-lit hallways of clinics and hospitals, but also in the warm light around a kitchen table, or sitting in the familiarity of a well-used living room. It comes when cousins ask us about their lab results, or when aunts and uncles come with queries about back pain and joint pain. When young family members are sexually active for the first time or when siblings are nervous about test results. It comes from stubborn family members who have refused to see a doctor for decades and say it’s all because they were waiting for you.
And for us, it isn’t a burden, no. It is a mantle of responsibility that we hesitate to grasp with both hands because we are unsure if our shoulders can carry the weight. It is dreading family gatherings because you know that there will be questions that are far more important than the ones that had you quaking in your boots as a fourth year clerk. It is wondering if you said the right thing, or made the right move or gave the right advice to your favorite aunt. It is watching your beloved uncle with a furrowed brow, wondering if he’s seen someone for the weight he’s lost and hoping to God that he’s just been dieting and it’s not something worse.
It is getting a phone call in the middle of the day, telling you that they received pathology results back and would you look at it? Because it says stage 4 pancreatic cancer and they’re not really sure what that means and would you help explain things to them?
It is sitting on the phone with all your books open in front of you, poring over biopsy results, laboratory test results, and listening to them talk about their latest check up with their doctor as you read and reread the same line three, four, five times because your eyes keep blurring. It is breathing before you say a word because you don’t want them to hear the hitch in your breath or the tremble in your voice that will tell them how much you love them and how scared you are, too.
This other side of medicine is about the side we fail to see, the physician we are to our families, to our loved ones, to our close friends, and chosen people who have supported, encouraged, loved, and fought with us while we chased a dream that we believed, some days, was unattainable. It is giving back to them, loving them with the truth, and allowing them the gift and grace of stark clinical honesty wrapped in love.
“There’s no real way to predict the time, but I would be mentally prepared, because if it’s not tonight, it’ll be sometime tomorrow.”