GHHS, Narrative

Under Pressure

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Kameron King, M1, Class of 2027

This patient was just like all the others, and I treated her the same. With genuine care and love. She was the last patient of the day. Unfortunately, her procedure was unsuccessful. She came into recovery slightly irritated and under the post-anesthetic influence. After a short recovery, we rescheduled her procedure for numerous reasons. I was a Patient Care Tech in the Main Operating Room at a large hospital and my job was to get her to the car safely. A job I had mastered throughout my time in this role, so I thought nothing of it.

I had achieved a wonderful rapport with her, I would even consider us friends following the unlikely events that would shortly ensue. However, she was unique, not only because of her demeanor and hopeful personality, but her physique. She was 375 lbs. This did not stop her from smiling, laughing, and enjoying life to the fullest. As we laughed, and chatted about our lives, her husband got the car. Little did I know, this would be when everything changed.

I follow the protocol to a T; lock the wheelchair, patient on my right, wide gait for easy car access, and a sturdy foundation. I help her out of the chair, one hand entangled with hers and the other grasping the waistband of her pants.

Her left leg goes up to enter the passenger side of the vehicle. SNAP!
Her right leg breaks.

She immediately drops to the ground screaming in pain. As an aspiring medical student, there were very few things I knew how or what to do. Blood was going everywhere. Given the circumference of her leg, I only knew one way to acutely stop the flow, squeeze it. With her thigh in a chokehold. I begin yelling for help. I asked for tourniquets, gauze, a stretcher, and a transfer board to get her to the ER. With the simple supplies I had, I wrapped 4 tourniquets around her leg and placed many layers of gauze around the exposed tissue and held pressure.

After a few minutes, other medical personnel began to arrive. It took approximately 6 of us to maneuver the board under her in such distress and move her onto the stretcher. As we entered the ED, I was asked by the attending to give a rundown of what happened. Honestly, I don’t remember what I said because it all happened so fast. I was also just so concerned about the patient that I couldn’t even think about myself. Until my nurse manager was made aware of what had happened and came to the ED to see me. Her first words were “Wow, you have a lot of blood on you.” After some time, I had changed and the initial shock of the events had gone down, the on-call orthopedic surgeon came up to me and said “You know, you started this, why don’t you come and finish it.” He knew I was entering medical school in the fall and since I had worked in the OR for a couple of years at that point, he let me scrub in and assist with the reduction and fixation of this wonderful woman’s procedure. This was my initial spark for orthopedic trauma.

I stayed that evening until 8:30 to make sure she made it to her room. Over the next few weeks, I would check on her to make sure she was recovering well. Not only did this experience propel me into a better understanding of what patients have to go through every day, but also the unexpected things in medicine and how to be a strong advocate for patients. I will never forget the patient who put me under the most pressure at such an early point in my medical career.

GHHS, Narrative

Delayed Delivery

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Azeez Baig, MS3, Class of 2025

Heading into my last shift of labor and delivery, I took some time to reflect on what many of my fellow colleagues and superiors have described as one of the most distinct memories of their medical education. Whether it was the adaptability necessary to complement the unpredictable nature of labor, the privilege to share the momentous experience of childbirth with families, or the multidisciplinary team all working towards a common goal, the labor and delivery unit served as a reservoir of education not only limited to academic, but personal growth.

My reflection was abruptly suspended, as I entered the workroom and was met with a board demonstrating nearly every bed full with laboring mothers. Shortly after, our triage beds also reached capacity. A lively start had already begun for myself and the rest of the night team.

The prior shifts leading up to this night were busy, but steady. Tonight was unlike any prior night. The amount of births that occurred over an entire night was the amount of births we had completed just a few hours in. As I bounced between triage, deliveries, and cervical checks, there was a constant amidst the exuberance. One patient I was following was scheduled to have a non-emergent c-section, and other laboring mothers with concerning monitoring led to her waiting hours longer than anticipated. Prior to entering the room, I could hear a flurry of Spanish between a few family members, and could sense uneasiness. In addition to the patient, I was met by her parents and the father, who was particularly vocal. He expressed frustration with the delay, questioning whether we had forgotten about his wife. A day as unparalleled as the birth of one’s child should proceed exactly how a mother envisions, and feeling forgotten is the last emotion we want our patients to associate with their experience. Acknowledging their frustrations, I apologized for the time spent wondering about our commitment to their care. Explaining the volatility of the service, including the urgency of delivering some mothers with concerning fetal monitoring and the shortage of team members, I saw the irritation dissipate from the room. As they thanked us before leaving, I was met with a wave of understanding and appreciation, a stark contrast from the initial energy in the room.

Experiences like this not only remind me of the privilege I have to study medicine, but also emphasize the values I hope to uphold as a future provider. While there is a standard of mastery of clinical medicine that I expect of myself, the physician-patient relationship is the foundation upon which all high-quality care is built. Accountability is a powerful tool to establish rapport with patients and, consequently, trust. Providers across disciplines are accustomed to the unpredictable nature of healthcare, where delays in care can be perceived as part of the ebb and flow of medicine. For patients, each tick of the clock can create a lasting memory, shaping their perception and relationship with healthcare.

While providers cannot alter the inherent unpredictability of medicine or the policies guiding their practice, they wield significant influence over a crucial domain – their mindset. Embracing this allows us to harness the unquantifiable facets of medicine that profoundly impact patient care. Elements such as active listening, genuine acknowledgment, and the conscientious avoidance of paternalism become potent tools within our grasp, enabling us to elevate the human dimension of healthcare.

As my last shift in the unit came to an end, my aforementioned suspended reflection resumed. However, I found myself far from my initial train of thought. Rather, I was left pensive, fixed on that patient. What I learned, the deliveries, the team, the clinical knowledge, was blurred by how I felt. The gratefulness, appreciation, and empowerment emanating from that patient served as the epitome of the type of health care I hope to provide for my patients. With the various players that comprise the team of healthcare, I strive to put my patients voice at the forefront, recognizing the impact of emotions on experience.

GHHS, Narrative

The Stone Baby

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Sarani G. Pachalla, M3, Class of 2025

As the surgeon carefully zapped through the final fascial connections, I felt the weight of the mass shift into my hands. My eyes went wide. It was 13 centimeters long, slate-gray, traversed by gnarled, maroon vessels, dotted with pale yellow, fluid-filled cysts, yet solid. I gingerly passed the mass to the surgical technician, who announced that it weighed 2950 grams. As the circulator wrote down the number on the board, I recalled my conversations with Mrs. G.

As a third-year student on the emergency general surgery service, I had seen her the day before for a possible bowel obstruction. Having not passed a bowel movement in days, she was extremely uncomfortable. Yet, she was in remarkably high spirits. Although the conversation was interrupted by her waves of nausea, we spoke about her daughter, grandchildren, and her recent journey with breast cancer. On physical exam, her abdomen was bloated, doughy, and tender to palpation. I remember auscultating high-pitched bowel sounds like fingernails on a champagne flute. Later, when I opened her chart, I found that her care was transferred to the gynecology/oncology service. Her chest radiograph showed bibasilar opacities. The CT of her abdomen and pelvis showed significant ascitic fluid and a large left-sided pelvic mass, and the gynecologists stated her presentation was consistent with Meigs Syndrome. She was scheduled for an exploratory laparotomy in a few hours.

Ascites, pleural effusion, ovarian fibroma: the triad of Meigs Syndrome flashed across my screen, refreshing my memory. This syndrome is an extremely rare presentation of a benign ovarian mass. I had memorized it for my board exam alongside many other triads, but I never thought I would see it, let alone in one of my patients. When the senior residents on both services agreed I could observe, I hastily made my way to pre/post to see Mrs. G.

“I knew I had a stone baby in there,” she laughed. It struck me how one could be so magnanimous in the face of something so baffling. “Make sure they weigh it. I’m curious.” I promised her I would. I noticed her shifting awkwardly, and I hoped that the surgery would ease her discomfort. We chatted more about her grandkids’ ballet recitals and soccer careers until we rolled back to the OR.

The resident confidently made the first incision. Then, as she pierced the peritoneum, the team began to drain liters of ascitic fluid. I exhaled, realizing I had been holding my breath. It was satisfying (and a little disturbing) how in an instant, the surgeons could remove the physical manifestation of the discomfort Mrs. G had been living with. It was also exhilarating to bear witness to something I had only seen in lectures and review videos. The surgery proceeded dynamically. The attending physician asked questions to us students, allowing us to connect concepts with reality. As she called out anatomical landmarks and coached the residents in surgical technique, I was in awe of her expertise. I craved to achieve the mastery it takes to understand every side of a condition, from the patient experience to the pathophysiology to the treatment.

I could not wait to see Mrs. G again. Albeit groggy from anesthesia, she was much less uncomfortable. When I told her that her stone baby weight 6 pounds and 8 ounces, she replied, “talk about a weight lifted.” Despite the fact that my role was so miniscule in the grand scheme of her care, I felt a genuine sense of fulfillment from my proximity to it.

GHHS, Narrative, Poetry

when does the work end?

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Aroog Khaliq, M3, Class of 2025

8 o’clock in the morning watching a red moon
blossom on a woman’s neck, holding open the
edges for the carpenters to saw and scrape, to
heal the way they know how—tiny blades, tinier
forges. the small, hurried movements of their
wrists a dance i cannot mimic with any grace,
and there is no room to stumble, not here.

10 o’clock in the morning, my own gloves stained
with blood from my little blunt efforts, retracting
that little moon into fullness, then snipping it into
an eternal crescent. the case is not yet over, even
when the deft hands still and away. still, there are
my bloody gloves, a woman under blue drapes,
wet and dry cloths on her sweet, slumbering face.

10:07, and i find my own deftness in the gentlest
touch, cloth wiping away orange iodine stains
around even the nares. good morning, ma’am—
you were here, and i, too, took care of you.

GHHS, Narrative

More Than A Patient

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Caroline St. Peter, MS3, Class of 2025

I am more than a patient.

I am more than a 90-year-old man with Parkinson’s disease and dementia. I am more than a widow. I am more than a man without his high school degree. I am more than a recovering alcoholic, and I am more than a helpless patient in the hospital.

I am a father, a grandfather, and a great grandfather. I have 3 kids, 2 of which are still living and involved in my life. I am a veteran who spent 30 months in Panama during the Korean war. I am a writer and a reader of fiction. I am a lover and a joker. I am survivor of alcohol misuse disorder who turned my life around, and I am a man with a story to share with the world.

During his admission, this patient had deterioration of his mental cognition and physical strength, which was impacting his nutritional status. His barrier to being discharged was ensuring he had enough nutrition and strength to go to a rehab facility. Attempts at medical interventions, such as a G-tube and appetite stimulants were unsuccessful, and the ultimate treatment ended up being personal engagement. We found out he had trouble concentrating and remembering to eat, and this is why he wasn’t doing so. Therefore, we shaped his care to focus on motivating him to eat with company and verbal encouragement. When I cared for him, I brought food from the floor to share with him in his hospital room, providing him with cues and companionship to enhance his care. As we sat and ate together, I asked him about his life, and he shared vast stories and immense wisdom I will always remember.

As an author, he encouraged me to write something down every day, even if it’s “boring or smart” so that I can have an account of my own story and how I see the world through my perspective. During our conversations, there were many instances where he found himself reflecting on previous experiences, such as his time in war and receiving help for his alcohol use disorder. Through this he showed me that no matter what stage of life or mental state you are in, to be grateful for what you have been through in life and reflect on that often. The past shapes who you are but does not define you. He also emphasized the importance of finding the joy in each day, no matter what the circumstances. He was vulnerable in the hospital and still focused on finding positives and continuously thanked us for our work. My time with this patient truly showed the impact that we as physicians have on our patients when we treat them as humans and the everlasting impact that patients have on us.

Creative Non-fiction, GHHS, Narrative

A Home for Baby

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Taylor Knowles, M3, Class of 2025

Do you hear crying?
Demanded to move, she
Swallows belongings
And cradles her womb.
”This property is private, or didn’t you see?
You don’t belong near people like me.”

Without help, she scrambles alone
Packing the items that make up her home.
An ache finds her spine like the ache in her heart
For a place to exist and create a new start
But the feet in her womb push her on
Down this path.

Two miles pass and she drops to her knees, crying
In pain as she falls on the street.
Without any medicine, what can you do for a pain so engulfing it hurts just to move?
And yet, in the stillness, the baby won’t rest.

Do you hear crying?
As she’s helped from the ground, the pain overcomes her
But, also, this sound is the cadence and chorus of
Something so sweet—the sound of a battered soul
Finding relief.

I enter her room, my notebook in hand, noting the
Name on her hospital band.
She shares how painful recounting can be, and as
She details her past miseries
I remember we all are just human.

Blood tests and images unfold the truth:
Infections are sprouting in scars from her youth.
Bacteria runs from her heart to her bones and, just
As she does, continues to roam
In search of someplace a new life can survive.

GHHS, Narrative

Patients are People

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Tyler Elmendorf, M3, Class of 2025

My first day as a third year medical student I anxiously waited in the neurology resident workroom as the team was assigning patients to students. The last two years of my life were in preparation for this moment; however, I was still overwhelmed with a feeling of inadequacy.

I soon found myself knocking on the door of a sweet 75 year old woman who was admitted for neurological deficits. Sitting tucked in her bed, she patiently answered my questions before we started looking at the cute pictures of her grandkids tapped to her walls. We shared a moment talking about her family, who was very dear to her but unable to visit her during her stay in the hospital.

Later that afternoon a team of two residents, an attending physician, and myself entered her room to update her on the results of her MRI scan. You could see the confusion on her face as the team explained her new diagnosis. She attempted to take notes on the discussion, but quickly gave up as she was unfamiliar with how to spell transverse myelitis. Seeing her disappointment, I turned to a new page in my notebook and wrote in big letters “TRANSVERSE MYELITIS.” When the team left the room I tore the page out and handed it to her. In that moment, her expression of confusion immediately subsided as she shot me a smile and a heartfelt thank you.

After rounds, I stopped by her room to check on her. She looked me in the eyes and explained how grateful she was for that simple gesture. She felt embraced by the people of the hospital, and that the individuals providing her care, truly cared.

I think about this moment often. While in many cases I can’t change the diagnosis, treatment, or outcome, this moment serves as a personal reminder of the kind of impact I can have when slowing down and thinking about the person in front of me not as a patient but as a person.

GHHS, Narrative, Poetry

Snowdrops

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Sheridan Scott, M2, Class of 2026

A child smiles softly, toy reflex hammer released
a plastic stethoscope still donned
as pudgy fingers fight to apply a Little Mermaid bandaid
over thick, black fur
where Mr. Snuggles’ heart would lie.

A girl counts silently, bag-valve-mask squeezed
a plastic stethoscope no longer sufficient
her hammering heart unwilling to still
as breathing for two people
leads her to wonder
how the woman became so ill.

Older now, naivety removed
like fallen autumn leaves
she knew the burden of illness
and the cruelty of disease,
reflected in patients’ eyes and
mirrored in those who held them dear.
The fragility, unpredictability of time
that causes a loved one’s screams
to overshadow outside noise and etch
a permanent mark in memory
as compressions neglect to replenish
ink into a pen–
unwritten chapters forever blank.

Yet, older now she knew that snowdrops bloomed
despite winter’s unforgiving chill
and knowledge mixed with compassion
achieves incredible feats
and gratitude in patients’ eyes
leaves her feeling unable to speak.
For medicine is most complex
and indescribable at best
to be entrusted with patient care
is an honor above all the rest.

GHHS, Narrative

Dual Roles: When Your Patient is Your Parent

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Daniel Yeremin, MS3, Class of 2025

Medical school has challenges for everyone; 2023 was especially stretching for me. One such challenge occurred during my neurology clerkship. On the second day of my rotation, I received a text that my father was going to the hospital for some head imaging, the same hospital in which I was currently working. He had been unwell for several days with what my parents had assumed was ‘the flu.’ This update surprised me. I met several family members in a waiting room downstairs as my father was taken to imaging. We waited for what I think was several hours before the doctors returned, explaining that they needed to admit him to the neuro critical care unit.

For nearly two weeks, my days were divided between attending to my patients during the day and spending my evenings and weekends with my father down the hall. At one point, I was even part of the rounding team who cared for my father. My father loved joking that I was on “”double duty”” as son and student. He would often request a prescription refill from “”Dairy Queen Pharmacy,”” colloquially known as a Turtle Pecan Cluster Blizzard. That was one way in which I was able to encourage him. Being faced with the possibility of losing my father was emotionally draining, compounded by the struggle to balance my educational commitments. I had to put aside my normal, strict routine to be there for my father and my family.

This experience highlighted several things that everyone already knows, but we often take for granted. Firstly, it reminded me that every patient is someone’s loved one. As medical professionals, we can forget patients have just as much of a life as we do with goals, hopes, and dreams. Secondly, all of us as medical students and doctors have seen very sick patients in the hospital. We have also all experienced, to varying degrees, the pain of seeing loved ones endure suffering or pass away. Getting to see both simultaneously allowed me to empathize more deeply with patients and gain insight into the daily challenges faced by patients and their families.

GHHS, Narrative

Delivering Care

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Marisa-Nicole Zayat, MS4, Class of 2024

“Patients do not care how much you know until they know how much you care,” my dad, a physician, told me as I started my clinical rotations. These words have echoed through my head during many patient encounters.

During my obstetrics and gynecology clerkship, I assisted on Jane’s cesarean-section. In awe of the surgeon’s skills, I carefully observed as the team operated. The skin and fascia were dissected, the uterus was exposed, the baby was delivered and immediately whisked by the NICU team out of the room, and Jane was sutured layer by layer. The operation was uncomplicated, so the surgeons went to their next procedure. Jane was left alone, lying on a narrow, cold OR table. I heard her say, “it hurts, goodness, it hurts so bad.” I wiped her tears and gently held her hand while providing comfort and reassurance. It was all that I could do. The next day I could not stop thinking about Jane. I felt compelled to check on her, and she welcomed me with a sadness in her eyes—she could not visit her baby in the NICU since she was non-ambulatory. I offered to take a video of Lucy, which we watched together. Tears rolled from Jane’s eyes, but these were different; these were tears of joy. The following day during rounds, I found Jane to be distraught. She had to send her older kids to her parents in Missouri since she did not know when she was going to be discharged. “I don’t know when I will see my kids next,” she shared. Tears of helplessness streamed down her face. I encouraged her to share her concerns with the medical team. I let my attending know about the situation, and he reassured her that she would be dismissed in the next day or two. When I reported when she would be reunited with Lucy and the rest of her family, she was relieved and finally beamed with delightful hope.

Another patient encounter comes to mind when reflecting on lessons of empathy in medicine. Sarah, a 24-year-old, was admitted for labor, which was complicated by fetal bradycardia. She was quickly rushed to C-section, leaving her mother behind to wonder what might happen next. I stayed by her mother’s side and comforted her during this time of uncertainty. Six months later, my dad came home, excitedly announcing that one of his patients told him that she had met me while her daughter was delivering. She shared the story and told him that I was very kind, compassionate, and made them feel at ease. What a privilege for me to be there, I thought to myself.

As a physician-in-training, I feel honored, humbled, and grateful as patients allow me into their lives at times of vulnerability and need. Medicine is truly the art of healing, for health is the product of a nourished body, spirit, and mind. My dad’s words seem to echo even more true as I further my training. What distinguishes an outstanding physician is the empathy and compassion that they have for their colleagues and patients—caring makes all the difference.