This is going to sound so sentimental, but I honestly have been thinking like this. And hopefully at least a few of my classmates have, too. Today the clinical lecture was about giving bad news, and dealing with patients who are dying. We don’t have much experience to relate to yet, but there’s something to be said for forewarning us. The main experience that comes to my mind is when I was on an OB elective, and the doctors I was with did an emergency C-section, expecting to save a baby in distress, and getting one that had been dead probably at least since the beginning of the surgery; and no one could say anything to the poor mother, because half the staff left the room with the baby, trying to revive it, and the rest were busy trying to close the surgery.

So. All the “you would think this would be common-sense” stuff about sitting down to talk, not rushing, talking to the patient’s level of understanding, being prepared to repeat the statement, or the session, not doing it over the phone, etc. And then a psychologist talked about being alert to when a cancer patient is having problems and needs non-medical help. And he ended up with a very moving exhortation that we were all too dumb to know anything but compassion yet, and that we should be careful not to lose that as we learn more. And it’s true. The reason I understand what patients are thinking is because I’m not yet trained enough to follow everything the doctor is thinking. I do *so* want to keep that ability. I don’t want to be the kind of doctor who breezes in, breezes through the exam, breezes through the diagnosis and instruction, and rushes out. The kind who sits on one side of a big desk, and plays with a pen while the patient trys to say something.

A few people said things about faith, and if you share religious beliefs with the patient, you can talk about that. Arg. What a horrible, dead, unreal way to talk about the greatest things in the universe. And I can’t help thinking, but this is about eternal life – my patient may be not only going to die, but going to hell too. What can I do? First off, will I ever be able to get any meaningful sentences out? And then, how can I help to change my patient’s destiny? But at the same time, I have to admit that in some circumstances, for a doctor to be witnessing could be just too much pressure to go along and agree, too much imposition by the “powerful” person. How does it balance?

Finally. The psychologist was also talking about “support network” and “defense mechanisms” and “coping mechanisms.” What a weird way to talk. But I am so grateful to my Savior; I can’t imagine living without Him. He’s my security, my guide, my future, my meaning. His love is constant and sure, and I don’t have to worry about him changing or disappearing. How can anyone go through medical school without him? Or stand to be sick? How can anyone face death without him? I can’t begin to picture the meaninglessness and emptiness of life without God.

Ok, I’ll try and limit it to objective occurrences for a while now. 🙂 This evening I’m going to a byomp party (bring your own milk product). I don’t remember ever going to a party without my family before. My goal is to spend not more than half the time standing by the wall in the corner, and to not turn bright red more than three times. And positively, talk to some third years and find out more about clerkships.

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