Maybe it is the fact that the clinic I have been placed in as a first-year medical student is primarily patients aged 65 and up, or maybe it is the tremendous amount of death we have all faced this year amidst the COVID-19 pandemic, but lately I’ve been pondering what it means to experience death in the field of medicine.
Recently, I had a discussion about death with my clinical skills preceptor, Dr. Ashley Huddleston. She started her career in emergency medicine, constantly in the face of death. She oftentimes only knew these patients as “ill” or “dying” as opposed to in primary care, where patients are seen in all facets of life. Dr. Huddleston has since changed fields of medicine to wound care and hyperbaric medicine: rehabilitation. Now, she gets to watch as her patients experience life. She gets to form relationships with them, often seeing them weekly. Yet, interestingly, she stated that this now makes death more difficult to swallow when it does come. These long-term relationships in outpatient medical care become so pronounced, as opposed to the sometimes unfamiliar nature of relationships in inpatient care. These humans are no longer strangers, but companions.
I cannot predict how I will face death as a medical professional or even as a human. But I do know I want it to be as intimate and raw as the day I had first experienced a healthcare-related loss. I was interning at an outpatient addiction treatment center that summer. It was unexpected. It was angering. It was reality. Here is an excerpt of my writing based on that day:
“A typical Monday morning as an intern at an intensive outpatient addiction treatment center is brimming with positive energy and new beginnings. Pulling up to the office, I would see the clients chatting and laughing on the front porch. Their communal cigarette smoke mingled with the sweet scent of gardenias in the summer air. Inside the center, which resembles a quaint pink cottage, the therapist, the medical director, and a pot of freshly brewed coffee would joyfully greet me. Monday mornings felt like sobriety was at our clients’ fingertips – until it wasn’t.
On July 5th, Monday morning felt dark. The porch was empty and humorless. Its usual inhabitants sat confused and quiet inside the group therapy room. The staff’s office doors remained shut. No one there to greet me. No freshly brewed coffee. Minutes felt like hours as we waited. Eyes scanned the room to see who was there and who was not. With heads bowed, the staff entered and took their seats. The silence was finally broken: ‘Joe; had overdosed and passed away. Joe, the one who everyone in the program looked up to, who was thought to be the last person this would happen to. Addiction had won, and its triumph rang loud in the silence of the room.
I have regularly come back to that somber July Fifth when Joe lost his fight. That day,
there was a sense of quiet perseverance. Reflecting back, I realize how difficult it was to retain such fortitude amidst tragedy. Nonetheless, each one of us left holding our heads a little higher — the patients, the therapists, the physicians, and me. The patients persisted in their fight for sobriety. The therapists and physicians persisted in their inclination to treat those suffering. I, aching for that same inclination, persisted in my pursuit of medicine. In that vulnerable moment, gripping each other’s shaking hands and wiping our weeping eyes, we were able to bridge the gap between patient, intern, and provider. There was a genuine camaraderie that day which left us all at ease.”
This memory is frozen solid within me. And it was what pushed me closer to medicine. In fact, without this experience, as tragic as it was, I do not believe I would be where I am today. It is not that it motivated me, it is that it matured me. It revealed to me the realities of medicine, while erasing the previously glorified view I had of medicine as simply healing.
Will this experience prepare me for future confrontations with death? Possibly. I just hope whenever death comes, I am surrounded by people in the most humanely raw way possible. No hierarchical labels of physician, resident, student, or patient — just fresh human emotions, compassion, and perseverance.