Circulation 36,825 • Volume 17, No. 2 • Summer 2002

Medical Student Offers Fresh Perspective

Kara Worley

June 2001. I had made it. My first year of medical school was really over. I had many people to thank for what I had learned. There was “Frank,” my cadaver. There were my professors in biochemistry, physiology, microanatomy, and neuroscience. I was well equipped to look at slides, read from a textbook, and regurgitate the origin, insertion, blood and nerve supply of any muscle in the human body. What would happen, however, when I was faced with a “real” patient? Would that patient be interested to know that the tenth cranial nerve is responsible for the gagging sensation when you put your toothbrush too far back in your mouth? I doubt it. How could I help my patients? How could I participate in someone’s care with the little bit of knowledge that I had?

July 2001. I was accepted into a 4-week anesthesiology preceptorship program at my medical school. No more textbooks. No more slides. I put on my scrubs and short white coat every morning and laughed at my reflection in the mirror. My reflection stared back at me, stethoscope neatly fold in my pocket. Would anyone really believe that I was a medical student? Did I want anybody to place any sort of confidence in the opinion of a medical student? Could I act the part? On one particular morning at the hospital all of my questions were answered.

I didn’t expect to have this sort of experience so early in my medical school career, but I am both saddened and grateful that I did. I never knew that losing a patient would hit me so hard. I never knew that losing a patient would teach me so much. I never knew that I would never forget a stranger’s name.

The morning of AS’s surgery I was in the preop area with AS, her husband, and the anesthesiologists who were assigned to the Acute Pain Medicine rotation. She was scheduled for removal of an adrenal carcinoma and a partial liver resection. AS and I joked about the colors of our hair, hers being “Clairol number 43,” mine “number 65.” We talked about school, and she congratulated me on my acceptance, and encouraged me to do whatever my heart desired. AS was 28, I am 25. I talked with her husband about the hardships and setbacks of being recovering methamphetamine addicts. AS and her husband had been addicts for 8 years.

When it came time for her epidural to be placed by the Acute Pain team, AS asked if she could hold my hands. I walked to face her and allowed her to hold my hand during the procedure. She squeezed my hands so very hard. I felt as though my fingers would have no blood left in them. A few moments later, epidural in place, her hair neatly pushed back into the surgical cap, and her husband at her side, she let go of my hands and laid back in her bed. She was ready. But was I? I said my goodbye along with the anesthesiologist who had placed her epidural. I wished her the best and promised that I would check in on her the next day. But for AS, and for me, there wasn’t a “next day.” On rounds with the Acute Pain team the following Monday, I asked that we might go by and check on AS. That morning I learned that AS had passed away that weekend. That morning I learned that my first patient had passed away. That morning I realized that someone who could be a stranger one moment, and a friend the next, had passed away. That morning I realized what it meant to grieve for a patient, a patient I had only known for moments, but will remember for a lifetime.

The next morning I awoke and dressed in my scrubs and short white coat. I looked at my reflection in the mirror. Would anyone believe that I was a medical student? Sure, I was dressed for the part. Would anyone put any confidence in what I had to say? Sure, I learned from AS that a gentle touch and kind word are just as important as the origin and insertion of muscle. Could I act the part? Sure, AS gave me every confidence that I indeed could participate in patient care. AS taught me more than 2 semesters worth of studying. AS taught me that I was not only a medical student, but had the capability of being a “student-doctor.”

Kara Worley is a medical student at the University of Arkansas for Medical Sciences in Little Rock, AR.