The Ones We Leave Behind
Image source: Unsplash
by Merrick Harris
At the end of the day, shift, or call, when their work is done, the physician returns home, they relinquish their duties and reunite with their private life, a privilege forsaken while the demands placed by their profession consumed their attention. Yet their work is never actually done, if “done” meant their patients were cured of all maladies and released from affliction. As the physician rests, the environment they leave behind continues to be laden with suffering. They escaped, seemingly, temporarily from the immediate reminder of that environment, to which, as all humans are, they remain inextricably linked.
A senior medical student was assigned to learn from a man with pancreatic cancer, a man enduring extreme pain and often surrounded by loved ones. Each day, the student interacted with the man, his wife, and the occasional relative sentinel, communicating the medical team’s plan for the man’s treatment and recovery. The man was in agony, untouched by his manifold infused medications, and the student related to the man personally, staying a little longer than was usual to ease the questioning minds that surrounded him. Remarkably, the man steadily improved, and the family was increasingly grateful for each visit from the conscientious student, who provided a listening heart for their hopes and worries. Two weeks passed, and when the medical student’s final day of the rotation arrived, he said goodbye to the man, now undeniably improved as he talked and joked with the student, inviting him to visit outside of the hospital sometime. The medical student was graciously thanked for his diligence and empathy, and the family wished him luck in school. Thus, the student’s journey in medicine continued—like a planetary mass along its trajectory, leaving a dying star behind and entering a new orbit—and he began his next rotation at a new hospital the following day. The light emitted behind him, from the man and his experiences with him, had illuminated the student’s path ahead, now certain in the type of medicine he would pursue. But, as tends to happen at great distances, the student did not realize that the light source behind him, that same day, had already gone out.
The responsibility to care for patients is temporary, and the time available to spend with them quickly passes; there are perhaps few professions more familiar with the brevity of life than those in healthcare. The medical student enters this reality during their training, with the respite that distances them from it diminishing greatly in residency—so designed to help the physician better understand patient suffering by taking part in it. Yet despite immense effort, at the end of their career, the physician leaves behind the same fact of sickness as when they embarked to cure it. The next generation of providers similarly assumes their Sisyphean mantle and comes to the recognition that, in the end, medicine only painstakingly prolongs the inevitable, when dust returns to dust. But, regardless of the difficulty of its path, there is still profound meaning in medicine, and, for the sake of the ones we leave behind, we must pursue it.
Patients are more than the sum of their biologic and chemical processes; they possess a constellation of beliefs, motivations, and experiences that are inseparable from their health and well-being. For medicine to have a lasting impact, its delivery must be combined with that which is unopposed by the physical condition before it—it must be accompanied by love. The relationship that blooms between a patient and provider transcends biologic treatments, overcomes physical limitations, and reaches where medicine alone cannot—to the human spirit within. Compassion and empathy are not mere supplements to effective healthcare, but they are integral to it. Without them added to the physical benefit medicine may provide, an infinitesimal benefit it remains.
We are all dying stars; how long we are perceived to emit light depends on how far it reaches, and if anyone cares to look.
Merrick Harris is a fourth-year medical student at the UTCOMLS
