Medicine

Original text is from Notes to the Class - First Day by Katharine Treadway, M.D

" When I was a third-year medical student doing my pediatric rotation, I was walking down the hospital corridor with my intern one night, making rounds on the reccent admissions. He stopped at the door of a patient who I knew was not on our service, but he said, ' I need to see this patient and her family. I know them because she hs been here several times this year.'

When we walked into the room, I saw a seven-year-old girl lying on a bed. She was brething the loud, liquid breaths I would come to know as the death rattle. Her skin wasbrilliant yellow, her abdomen massively swollen from the Wilm's tumor that was killing her. She had no hair-- the effects of her many bouts of chemotherapy-- and her limbs were stick-thin.

With her were her parents and both sets of grandparents. When we walked in her mother stood up. My intern walked over to her and put his arms around her, and they stood, silently, holding each other. After a few minutes, the mother stepped back and, looking at her daughther, at the unbearable scene before her, said, ' You know, I never thought I would want her to die, but I want her to die. Somehow, when they said there was nothing more they could do, I pictured her in a field of flowers and she'd just be gone. I never thought it would be like this.'

My intern taught me a profoundly important lesson that night. Many docors would have walked by that door because everything had been done. the diagnosis had been made, the correct treatment given, the complication appropriately treated, and now the girl was dying and there was nothing more to do.

What my intern taught me that night was that there was one more thing to do-- to go into that room and offer whatever comfort his care and concern could bring, to bear witness to the pain of that family. In the end, it was as important as anything else that had been done for that child. In the long years ahead, if you asked the mother what she remembered of that time, I suspect that one memory would be of my intern holding her. The lesson he taught me was that in the practice of medicine, the person you are is as important as what you know.

This is one of the extraordinary things abour medicine, I say: it is an intensely interllectual endeavor, demanding that you learn and understand an enormous body of information and that you constantly update that information as new knowledge becomes available, but it is also an endeavor of your heart. At the same time that you are learning abour disease and diagnosis and treatment, you are learning about illness, the patient, and yourself."