Seemingly Sisyphean

Stefano Byer, M3, Class of 2022

Now, halfway through the crux of medical school that is third year, I often sympathize with Sisyphus. I begin each week with new people, new patients, new criticisms, new stresses, new stories, new lessons, and once I’ve finally adapted…the next week beings—the stone rolls down the hill: I begin anew, and I love it (unlike Sisyphus).

I love the privilege of stepping into patients’ rooms and lives—I view my crossing of their doorway as symbolic for our lives intersecting in that moment in time. This year I’ve been honored to witness pregnancy checks, deliveries, newborn visits, sports physicals, Medicare wellness checks, end-of-life discussions, and the list goes on. In reflecting on all these moments, some wonderful and some less-than-wonderful, there is a patient story in particular that remains poignant—let me share it with you.

She was one of my first patients as a third-year medical student. I met her after her aneurysm ruptured and she’d spent the last few days in a coma on her living room floor. Found by her sister, who had visited her because she was worried about her relapsing, our first encounter was when she was having a drain placed in her brain to decompress the pressure from the blood that filled her cranium—I was bracing her head to steady the trephination.

I was witness to her entire hospital stay: the last 5 days of her life. From the drain placement, to her aneurysm being surgically silenced to prevent further bleeding, to her extubation and subsequent demise—it was a rapid descent, yet a long five days. I was present for her loving sister’s quiet weeping, which became the backdrop after the physicians shared their grim prognosis. Rounding on her as a team was always brief, as we were all waiting for the inevitable, hoping for a miracle. Silently, she lay with her machine-pumped breath, listening to our morning mutterings. I recall standing in the doorway, listening to these rhythmic gushes of air, erratic beeps, and timid weeping from the dimly lit corner—cacophonous is the futile fight against death.

I am both drawn to and repulsed by this twilight zone of patients in extremis. Repulsed due to the ICU environment’s tendency to rupture hastily stowed away memories of similarly lost loves ones of my own. Drawn by the awe for human life and the neurophysiology that defines it, and a wishful fight to save that loss from others’ hearts.

Walking down the sharply-lit neuro ICU floor, in glancing through the glass doors I see my reflection, and with it like a grim mistletoe, the sword of Damocles that hangs over us all—how fortunate we are for good health, how worthy of a fight it is to preserve for others, until our own sword falls.

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