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2022 LMS Essay Contest 1st Place, Medical Student Category: Katherine Breetz

I have wanted to be a pediatrician my entire life. Being the oldest of eleven made taking care of children feel like the best way to live my life, and definitely the most natural. Thus, I have always pictured the patients that would most impact me would be from the pediatric population. My first two years of medical school were full of stress and confusion and, frankly, led me to question my decision to start medical school in the first place. So, imagine the surprise when during my third year of medical school, not only did I rekindle my desire to become a physician, but it was a 70-year-old woman who reignited my passion for the practice of medicine and in an entirely different direction. She has been there, in the forefront of my mind, since providing her care. And there I hope she stays.

For the first four weeks of my Internal Medicine rotation, I was just waiting to progress to Pediatrics. I’d seen grumpy, old patient after tired, old patient and I thought I needed a break from that to see a smiling, energetic, little face. This changed one morning when I was sent down to the Emergency Department to see a patient admitted overnight. In the room laid a very uncomfortable appearing woman who was clearly struggling with pain. The only thing I had been told before entering her room was, she had widely metastatic cancer that was refractory to treatment, so I was expecting the uncomfortable appearance, and was thinking to myself that she had more of an excuse than any to be tired and grumpy. Fortunately for me, she was the opposite.

When I arrived, she sat up and proceeded to tell me her story, calling me “honey” every other word. She was there because of the pain but was very hesitant to take any pain medication as her niece had recently died of an overdose. She wanted medical advice and support as she realized she was dying but did not want to make herself numb in her last days. Her hope was to better control her pain, but she also wanted to be aware and able to appreciate her last months with the family she loved. Her daughter was with her and struggling to express how difficult it was to watch her mother in intense pain, while the patient also had difficulty expressing how much she wanted to be aware and present with her children and grandchildren. I was able to see her for a few days in a row before she was discharged to hospice, and each day another story showed me the breadth of her life and importance of helping all patients, not just the happy, healthy children. I would not have thought about how meaningful it is to have someone bring you coffee each morning when stuck in a hospital bed, or how hard it is for both the patient and their family to be in pain. And I would not have taken the time to spend every morning of that week watching the sunrise from her window as she did not want to miss any before her departure from this world.

We may not have been able to reverse her cancer, but we were able to help her ease the pain and give her the time with her loved ones she desired. Speaking with her reminded me of the reason I went into medicine, which is to help those in need. She opened my eyes to the positivity of helping the elderly too, although they are not as young and happy, they can be so full of lessons and respect. It is my hope she will stay with me throughout the rest of my career. Luckily, I have already noted some of her spirit in the rooms of other patients I encounter.

She was there in the 77-year-old man with Idiopathic pulmonary fibrosis who also needed someone to talk to in the mornings. His wife had died three years ago, and although he was hospitalized for an acute respiratory exacerbation, he always looked his best when we would go sit and chat about the weather.

She was there in the 12-year-old boy with Autism who was unable to voice or adequately express his concerns but would settle down with the company of another person in the room.

She was there in the 55-year-old male’s family members after he was no longer a liver transplant candidate, but whose family wanted to spend their final moments together and with him pain-free.

She was there in every patient room throughout my PICU rotation in the parents fighting to understand their child’s illnesses and help them get better in any way possible.

The time I spent with her not only reignited my passion and desire to practice medicine but will hopefully guide me to exercise more patience and display for compassion for all my patients going forward. She had every possible excuse to express her pain through frustration, but instead she chose to show grace and respect to all of us, regardless of whether we came in her room at her best or her worst comfort level. She is an exceptional reminder of what the best versions of ourselves should look like, and made it very easy to provide the most holistic care and spend more time in her room. The memory of my time with her serves as a reminder that everyone of us has a story to tell. Each patient will have their complexities and although some may express them with anger, there are others that will present valuable lessons to be learned. One is not better than the other but entering patient encounters without expectations has helped me be a better student and hopefully a better physician.

Finally, she will be there as a reminder that all of us are human, and although we do have medical needs, we also have the personal desire for interactions to connect with others. We owe it to our patients to spend time in their rooms listening and connecting with them. After all, “the secret to care in a patient is in caring for the patient,” and sometimes we can express this by going out of our way to bring them a coffee, sitting down and listening to “just one more” story, or just by being there when they need us.