The One Where the Patients Taught Me

(Disclaimer: As per usual, identifying information has been changed or omitted.)

I’m lucky enough that my school recognizes the importance of learning from patients and their families, and as such, organizes a home visit for each student with the family of a child with some type of developmental disability. At my orientation for pediatrics, I was handed a slip of paper that detailed William’s disability: he was a teenager with incredible mental disability and minimal language and toilet training skills, but no working diagnosis.

With my almost nonexistent experience working with disabilities, I was perhaps more than just slightly nervous for the encounter, which took place one evening after my clinical responsibilities. I spent the ride to the house contemplating what questions should be asked and how to ask such sensitive questions in a respectful manner. I wondered how difficult it’d be to interact with William and his family.

But Mr. and Mrs. B and William were waiting for us with open arms and dinner on the table.  William, a small, thin boy for his age, smiled shyly at us, giggling and offering a hand for a high five when prompted.

After negotiating that William could have a soda with dinner as a reward for successful toileting earlier that day, we sat down to dinner, and the floodgates opened. Interrupted only by William’s prompting for certain stories to be told, Mr. and Mrs. B began pouring their hearts out, recounting countless experiences with doctors and the community and their son, providing more lessons to me than they could ever know.

I was reminded, once again, the importance of just listening: Mrs. B couldn’t thank us enough for letting her “gripe” about her daily stresses in dealing with a child that is trapped at the level of a toddler, the kind she feels guilty constantly burdening friends and family with.

I was reminded that often parents know best, especially with children who aren’t quite “normal.” They recounted a particularly scary period when William was nauseous and acting very tired, laying down on the floor at every opportunity. Despite the parents’ insistence that something was wrong with the shunt in his brain, the physicians sent them away since William wasn’t demonstrating typical signs of a headache, the most common symptom of such an issue. “But he wouldn’t know to hold his head when it hurt,” Mr. B explained, and it would later be found that he was leaking fluid from his brain.

I was reminded how scary it can be to not know a diagnosis, and how important it is to be honest with the parents, even when the news is not ideal. Time can be so hard to come by in medicine, but with tough diagnoses (or lack thereof), it’s SO important to take the time to answer the family’s questions and help them anticipate what is to come.

I was reminded of the fundamental goodness and acceptance of our society. I was concerned we’d hear heartwrenching stories of classmates who bullied William because they never made it past the drooling and lack of communication, but instead, Mr. and Mrs. B relayed countless stories of high school classmates of William’s who take him to baseball games, or of the community members who love to observe William’s enthusiasm at sporting events. William has even had the opportunity to meet some local celebrities, and beamed as he showed me his picture with our hometeam NFL quarterback.

I was reminded that physicians are often the first link to resources for care outside of the office, and that they should remain aware of the various tricks to save money or improve quality of life for these patients. Mrs. B was grateful for those who had taken the time to help connect her to other services to benefit William and the family.

But above all else, I was in awe of the strength of the family. Despite rarely having time to themselves, Mr and Mrs B show no signs of resentment toward their son or their lifestyle, instead embracing and tackling the challenges that come with caring for a disabled son day to day. The love and support within the family was palpable, even among William’s siblings, who acknowledge lovingly he’s just as annoying as anyone else’s brother.

So William and family: this one’s for you. Thank you so much for welcoming me into your home, providing me a home-cooked meal, and allowing me to see into your life in a way that will forever change how I approach my patients, but thank you mostly for allowing me the chance to get to know a happy-go-lucky, smiling, welcoming young man with a fervent love for M&Ms and sports.

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Side note: Yes, I’m alive. I managed to survive pediatrics, just barely, and I just started my family medicine rotation, but we’ll talk about that more later.

Until then,

K

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The One about Eating in Medical School

Apologies for my recent hiatus: I’ve still got a raging pharyngitis. It’s always fun when a doctor literally says, “I’m worried about you,” and you realize that you’re currently speaking in the “hot potato voice” you’ve heard reference to but never understood. And when your midterm evaluation turns into a physical exam where it’s documented on your records that you have “exudative pharyngitis and cervical lymphadenopathy x 1 week” and that you should get more rest, it’s probably time to stay home. But anyway, easing back into routine with an easy blog post: all about food in medical school.

I’ve alluded to this before: eating in medical school gets a little bit tricky, especially in the clinical years. Between a tight budget and a busy schedule, cooking and grocery shopping aren’t always high on the priority list, but eating out costs pile up quickly. So I’ve decided to dedicate this post to my tricks of the trade: how I’m managing to eat in medical school.

  1. The Art of the Free Food

Medical school is a wonderland of lunch talks and snack breaks and leftover food from staff meetings abandoned in the lobby. I used to have friends who ran a sort of patrol around the school, looking for opportunities to eat and sending out mass texts when they found a jackpot (including one time when they crashed a staff Christmas party). And let’s be serious: any mention of free food sets med students into a frenzy, kind of like this:

Last one there gets the vegetarian option!

So here’s how it works:

No interest in otolaryngology? It’s okay, you’re probably interested in free burritos, and if you’re lucky, you’ll stumble upon a great speaker at their lunch talk. (True story.)

Normally not into picking up sandwiches from who knows where abandoned on a table for who knows how long? You’ll quickly get over that and learn to be grateful for good timing. (Somehow, even hypochondriac med students are able to overlook the food poisoning potential on this front.)

Not really into Indian food or the vegetarian sandwich? But it’s free. Everything tastes better when it’s free, and I’ve found I’ve gotten a lot less picky when it means I’m not going to have to cook or buy food.

2. Speak softly and always carry tupperware.

Toward the end of first year, I realized something: many events with free food have leftovers. Leftovers that get abandoned in the lobby for lost souls to stumble upon… or worse: they get thrown out.

But not on my watch. I learned to start carrying a Tupperware in my bag at all times, just in case there was leftover food that I could take home for lunch the next day. It saved me so much time and money, and I knew that portion of the food wasn’t going to go to waste. It’s actually pretty funny to watch the eyes of first years light up when they realize how ingenious the idea is.

My non-medical school friends tend to ask me all the time if I’ve brought Tupperware to various events. I always deny, but secretly, I either have it or I wish I did

3. Cook Enough to Feed a Small Country

One of my most convenient tricks is to plan a week or two worth of meals, do all of the grocery shopping at once, and then dedicate an afternoon to cooking all of them. I always make sure to make portions large enough to provide multiple meals, and it’s kind of nice to do all of the chopping and baking and cooking together so that I can come home to home-cooked meals in my fridge or freezer.

And it means you can cook nicer meals, and not get stuck eating quick frozen food or take-out all the time.

The result of my efforts a few weeks ago: Pineapple Fried Rice, adapted from a recipe from Closet Cooking (click image for link!)

4. Except, I have to admit another go-to: Frozen Foods.

Because sometimes you need something quick and easy that you can inhale and fall into bed. I guess it’s better than the week I ate Oreos for dinner.

5. Granola bars.

The best way to survive a long day on the wards is to find something pocket sized to sneak bites every once in a while. Because let’s face it: sometimes you never leave the OR long enough to eat that giant portion of fried rice in your locker.

6.  Spaghetti is flammable.

Because once, I had this idea that I’d just throw together a quick dinner, so I dropped my long spaghetti noodles into the pot with the dry ends hanging out, like I have several times before. Except this time, the burner had a mind of its own and sent fireballs shooting up, turning my pot of boiling pasta into a bright, fiery mess reminiscent of the Olympic torch.

This is solely a re-enactment of this event. (Credit: Liberty Fire Dept.)

That’s right: I set spaghetti on fire. Applause and compliments not necessary.

And those are my words of wisdom for today. Happy eating!

K