Tag: Narrative

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

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

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

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, Poetry

Love your Patients

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Simon Longhi, M3, Class of 2025

Love                       your Patients.

Her voice shakes
Gaze averts down, slowly,
hiding welled-up eyes.
But she takes a deep breath,
and states
for me:
“I feel like I’m falling apart inside… but, no.
They’re my kids, they’ve got their own lives,
… I can’t put that burden on them.”

I glance down, quickly,
at my quadrant-folded, wrinkled sheet of paper.
Lurching for an anchor– the right thing to say next,
from my scrawled, inadequate
pre-charting mess:
Myra M., 59yo lady, hx MDD moderate in remission, GAD
HR rep, three adult children, married 33 yrs
Lives w/husband (restaurant mgr, stopped working)–
recent frontotemporal dementia dx.

Myra was losing her husband, quickly.
She was becoming alone, slowly.
Her wrenching words,
yet suppressing outright despair.
Self-aware weakness,
yet wearing strength for others.
Devastating dichotomy.
I know this. Feel this.
My lips quiver, my own space behind the eyes
wells up,
because…
I saw my mom, in Myra.

My mom sacrificed everything,
for my sisters–
Autistic. Aggressive. Screaming.
Incontinent. Inconsolable. Seizures.
Innocent. Utterly un-independent.
Too much.
Worry constant, peace extinct.

The whole story feels untellable.
As a kid, processing this,
Puts the proverbial tip of the iceberg
To shame.

But Dad worked, paid the bills,
And really, I got to live free
without that wrenching responsibility.
Because, my mom insisted on it.
… Well, not in words, mostly unspoken
But I promise you, she lived it,
for me.
She may as well have said:
“Simon, I love you, do all that you ever want
with your life – Don’t worry about your sisters, please.
Keep going, don’t hold back, this is not your burden,
I got it. The world is yours, and this burden is mine.”

All of that past
is here now
in this clinic room.
In the span of a second or so, I feel everything
for this patient I just met.
I fold and re-fold the edges of my paper
Grip my pen more tightly,
as if it can absorb my nerves,
and contain a shudder in my chair.
Myra… mom… meaning.
Beautifully blurred lines in my mind.
I know where my compassion comes from,
and I’m proud of that.

But, I’m the healer now.
I have to be strong
this time– for my patient
For Myra.
FOCUS, on taking deeper history,
FOCUS, on forming treatment plan.
Love your patient, sure,
but don’t fall off that cliff of transference.
Yes, take in the view
That harrowing expanse.
But teeter well
on that cliff’s edge
Stay standing.
It’s your solemn duty.

Okay, deep breath–
next questions,
but still, keep listening.
Watery eyes are fine,
but no tears,
not right now.
Guide Myra on.
It’s my calling, my honor–
what my mom
Selflessly
imagined for me
all along.

I love                  you.

“Oh. Okay. ‘Burden’. Tell me more about that.”

GHHS, Narrative

Two sides

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Ryan Asauskas, MS3, Class of 2025

So one of them is gone
She just stared ahead
She had one child left inside her and could not dwell on
But, Her face, it grew cherry red
But, Her eyes swelled with tears
But she had tried so hard to make a life
But come to pass was her greatest fear
She would see her child in the afterlife
So long had she tried to make a child
So long had she waited for that new baby’s cry
Now her new life will have to be reconciled
She said goodbye and thank you
She left

So I have another one of them
She said with glee
She had one less child inside and one more outside a new gen
With 5 children now she could not believe her happy reality
Her family thanked and cried tears of joy
All her pregnancies were happy stories in the end
Each one ended with a boy
With only happiness did she have to contend
She said goodbye and thank you
She left

One patient lost a whole world
One patient gained a world unique
One patient after another
One room after another
One emotion after another
One life and one death after another
One face after another
Just one day after another

How do you do that when all you hear is:
Don’t you know that, you’re a doctor
You went to school for so long
I expect you to know biology
I expect you to know chemistry
I expect you to know anatomy
I expect you to understand me
I expect you to help me
I expect you to consul me
I expect you to comfort me
I expect you to save me
I expect you to save my child
Why did you fail

How do you stop this vocation when you hear:
Thank you for listening
Thank you for talking to me, that’s all I needed
Thank you for taking care of them, we couldn’t
Thank you for helping me
Thank you, I feel much better
I trust you doctor, do what is best
I trust you to make the right choice
I trust you with my family, my child, my wife
I trust you with my life

GHHS, Narrative

Bearing the Burden

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Dylan Wentzel, M3, Class of 2025

It was an ordinary day on the Benign Gynecologic Surgery service, filled with routine cases and hurried movements. I had just finished assisting with the usual procedures when I glanced over my schedule and sensed that the upcoming case, a dilation and evacuation, was far from ordinary. This case was different—it carried a weight that set it apart.

The procedure involved a young couple who had recently suffered the devastating loss of their first child. As I met them, grief clung to the air. The wife, still immersed in sadness, was led to the operative area with tears streaming down her face. Stepping into the operating room, a palpable shift in atmosphere enveloped us; everyone acknowledged the profound significance of what we were about to undertake.

As the D&E progressed, we faced the solemn task of removing fetal parts from the uterus. It felt surreal, as if we were handling the fragments of a future that would never be realized. Sorting through the remnants of a life left me questioning the essence of this medical intervention—it didn’t align with my perception of medicine.

As the procedure neared its end, the attending physician seemed to grasp the internal struggle I, and perhaps any medical student, was experiencing. She took a moment to pull me aside and shared a perspective that resonated deeply: performing this challenging procedure was a means to spare the patient from the anguish of going through labor to deliver a nonviable child. She conveyed, “We bear this burden so our patients don’t have to.” In that moment, the realization struck me that this encapsulated the essence of medicine—an intricate balance of confronting hardships to help shield patients from unbearable realities.

While medicine encompasses incredible aspects, it also introduces challenges that test our resolve. There will be difficult days, but our duty is to bear burdens so our patients can navigate their struggles with as much ease as possible. The arduous moments serve a purpose—to make other lives a little better.

After the procedure, we approached the husband to reassure him. Witnessing the attending physician comforting him, she handed over a small piece of paper bearing the footprints of their lost child. It was a poignant reminder of the honor and responsibility physicians carry, being present in patients’ lowest moments. I walked away with a profound understanding of our duty—to share the weight of these moments with respect and reverence, embracing the privilege of standing alongside our patients during their most challenging times.

GHHS, Narrative, Poetry

Sonder: A Call to Kindness

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Hunter Hiegert, MS3, Class of 2025

A mob of doctors, an entourage of studentsEager to impress, chock-full of prudenceAs rounds persists, patient rooms fly byDespite their smiles, we don’t even say hi
 
And in the midst as I begin to wonderIn creeps the feeling of immense sonder.Countless lives unique from you and me.Limitless moments of hope, sorrow, and glee.
 
Stories untold, with lives unknownDreams fulfilled, yet candles unblownThe realization experiences are infiniteA potent sense of overwhelming belittlement
 
These fleeting thoughts, quick as a breathStill time marches, inevitable deathYet in this vastness, a purpose revealedTo live with kindness, a weapon to wield
 
Each life in need, a beacon of opportunityAwake each day, emit positivitySo no matter the duty, large or smallEmbrace humanity, our selfless call

GHHS, Narrative

The Sound of Healing

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Jonathon Liu, MS3, Class of 2025

Throughout my clerkships, I have encountered many patients, each teaching me valuable lessons about disease processes, pharmacology, and the underlying science of medicine. However, beyond the technical knowledge, it is the patient interactions that I cherish deeply. My experiences have also underscored the importance of bedside manners and the establishment of a strong rapport with patients. The art of delivering compassionate, patient-centered care is fundamental, enabling physicians to truly connect with their patients, understand their experiences, and facilitate more effective healing. Humanism is, indeed, a quintessential element in medicine. During my Internal Medicine Clerkship, I had an encounter that brought this abstract lesson to life—fundamentally shaping my approach to medicine.

In the ICU, I met a patient grappling with unstable atrial fibrillation and a host of cardiovascular complications as a direct result of poorly managed type 2 diabetes mellitus. Yet, his physical ailments barely scratched the surface of his suffering. Initially, I entered his room to gather his medical history using the comprehensive approach taught at my home institution—covering chief complaints, medical history, family history, social history, and more while simultaneously being expected to efficiently collect and report the necessary information to our medical team. However, our conversations soon unveiled a narrative steeped in frustration, anxiety, and a profound sense of abandonment. He shared his long struggle with type 2 diabetes mellitus and the daunting side effects of metformin that had overwhelmed him—nausea, vomiting, bloating, and a repulsive metallic taste. When he sought help, his concerns were dismissed, leading him to resort to unproven supplements. His condition deteriorated, necessitating insulin, which he avoided due to fear of experiencing similar or worse side effects.

Recognizing the depth of his disillusionment, I made a commitment as his student doctor to work to unpack his fears and concerns. I promised my patient that I would advocate for him to my medical team. Day by day, beside his bed, our conversations blossomed beyond healthcare, touching upon his life, fears, hopes, and dreams. I learned of his service as a war veteran, his passion for exploring local restaurants, his and his wife’s adventurous spirits, and his profound kindness and love for his family. Our conversations became something we both looked forward to daily. These moments of shared humanity reminded me of the significant impact empathy and active listening can have on kindling a relationship with my patient.

Together, we navigated his health fears, exploring alternative treatments while his concerns and preferences were at the forefront of all decision-making processes. This patient-centric approach reignited his motivation to manage his diabetes, marking a pivotal shift in his treatment journey. By forming a strong bond through daily interactions, I became a more effective advocate for him, amplifying his voice, supporting him through his improvements, managing side effects, and navigating setbacks.

This experience reinforced a fundamental truth: healing transcends the physical aspects. Medicine demands humanity, which can only be achieved through nurturing strong, trusting relationships with patients. When we take the time to genuinely connect with our patients, listening intently and empathizing deeply, we can significantly transform the quality of their healthcare. At the heart of medicine lies this simple, profound principle: to care for another is to see them, hear them, and stand with them in their moments of vulnerability. This encounter has indelibly shaped my understanding of what it means to heal, reminding me that the core of humanism in healthcare is the profound connection between a doctor and their patient.

GHHS, Narrative

Remembering

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Cooper Root, MS3, Class of 2025

My first trauma surgery call shift was on a regular Thursday night. It was very slow and nothing eventful happened most of the night. I was able to sit at the hospital and complete all my studying, and even managed to get plenty of extra work done as well. I went to sleep, the pager had yet to go off, and it seemed like it would be a straightforward night. At about 3:30 AM my pager went off multiple times in a row – Level I trauma ETA 5 minutes. I scrambled to get ready and hustled down to the trauma bay. I arrived to hear there was an apartment fire and we actually had 3 individuals arriving simultaneously. I knew my role and prepared to fill out the injury sheet, cut clothes, grab blankets, and anything else to help. To my surprise, I did none of that when I saw the patient. A young girl was wheeled in with no pulse and CPR machine on her chest. She suffered extensive burns to her entire body. The CPR device was removed, and I was thrust to the bedside to immediately begin chest compressions. In a state of shock, I began this process, frequently getting told “faster, deeper, pick up the pace”. After a few minutes that felt like hours, someone relieved me of my duties but to no avail. The patient never regained a pulse and was pronounced dead within minutes of arrival. Rather than take time to process and grieve, two more patients get wheeled in with other injuries from the fire as well. I was immediately sent to go help those patients, without a moment to reel in how I had felt from one of my few direct experiences with death.

Medicine can be so fast paced and dynamic, one of the many aspects we all love about the field. We are considered excellent in these moments of sudden change, creating a fully functioning team with assigned roles and responsibilities in a matter of seconds. It is fascinating how effective a few random healthcare workers can become a multi-functional fluid machine in moments of extreme chaos. But often we tend to act exactly like that, a machine, once these moments pass. Calculated, automated, analytical, and unemotional. The team did a great job, and I felt as if they all truly cared about what they were doing and trying to save this woman’s life. As the years go by and these instances occur often, it’s human nature to glance past the gravity and finality of what we deal with on a daily basis. I am likely more guilty of this than anyone, as I was essentially numb to this experience until writing this essay, and fully comprehending that someone’s life ended in front of my eyes, someone younger than myself. I couldn’t tell you a thing about this person unfortunately, other than her injuries, and that we did what we could to save her, and that is a strange feeling as well, considering most of my experiences with death have been older family members, or at least people I know on a personal basis. How did she spend her last day? What were her goals in life? What did she think about before drifting off to sleep? Questions that will never be answered for me, and an experience that will never be taken from me. Ultimately, what this experience did for me was to provide a challenge. A challenge to never lose sight of the person within the patient, rather than the disease, injury, or pathology that may be affecting them. Sometimes the best way to honor a patient is just put your head down and do everything you can to save others and take solace in the fact that you will do everything you can to save the next.

To her friends, family, and loved ones – I am truly sorry for your loss. I wish there was more we could have done. I hope to honor this experience with this essay, which is nothing compared to having her here with us. I hope you all have found some sense of solace in your loss. She will not be forgotten.