While we often get caught up in the medical details of a patient’s diagnosis/illness as healthcare professionals, this piece portrays that each patient has a story. Every person is a world unto oneself. As William Osler said, “The good physician treats the disease; the great physician treats the patient who has the disease.”
This piece that I drew is about a breast cancer patient that I encountered on my one week in the breast cancer surgical team on general surgery. This picture represents a female who had a right mastectomy with a new mass noticed in her contralateral breast. This symbolized the body dysmorphia and self image insecurities that these women face. Many of these patients that I talked with discussed how they felt embarrassed and guilty about these feelings because they felt like they should be happy that they are cancer free. When working with the surgical team, I found that these feelings were validated and time was taken to comfort and empathize with the patients while providing them support. This strengthened the doctor-patient relationship and just by validating someone’s feelings and emotions goes a long way. These women felt empowered after these discussions and glad that these discussions were happening. They even appreciated that the surgeons took extra care in creating a cosmetic outcome for them whether it is a discrete incision or for future reconstruction consideration. This taught me to always listen to my patients, give time for them to ask questions, and to validate what they’re going through.
For my reflective piece I chose to use a photo I took on a walk I would often do while commuting to work. A lot of the discussion during the humanism workshop was on the concept of time. Taking a step back and spending that extra time with a patient. In these moments you slow down and think about the bigger picture instead of all the small things that each of us go through every day that can build to overwhelm us to lose sight of what we are really there to do. I think this photo represents taking a step back, becoming aware of your surroundings, and fully being in the moment. It is a reminder that when we are the most stressed and feel like we don’t have the time those are the moments we need to try harder to be in the moment. Those will be the patient interactions that are fruitful, memorable, and therapeutic.
“This plant was uprooted from its home, broken into smaller pieces, went through drought and lack of growth, but somehow was able to persevere and make it into a new place, with new growth, in a new environment. It may be different, but there is an opportunity to grow”
Left: you’re in your home, comfort, security
Middle: uprooted, like a cancer dx, and you feel isolated, alone, weak, etc
Right: rooted and planted, such as when a surgery finishes OR when you find comfort and trust in your health care providers.
These are the stages of regrowth.
I chose to highlight in my digital drawing how unique the experience of surgery can be for each patient, as well as the specific considerations of each patient’s condition(s) and operation. I found that during my rotation, the surgery teams had to be reflexive and adapt to each patients unique pre-op, intra-op, and post-op needs in order to facilitate the best outcomes.”
“The case of the day!” echoed down the hall.
Then in came the doctor, imposing and tall,
With a nurse and bright-eyed student in tow,
Something important abreast that I would soon know.
Shifting uncomfortably, I prepared my ears,
For words that I was simply not ready to hear.
“Rare, difficult, unlucky and large… “
This mass in my leg was now in charge.
“Surgery, radiation, scans and chemo…”
Many dizzying words that I did not know.
With my heart pounding like a drum in my ears,
I wished my family were here to assuage my fears.
But in this foreign land, scared and alone,
The voice of the doctor continued to drone.
“Next steps, referrals, biopsies, and labs…”
I just missed my brothers, my mom, and my dad.
I hoped I could see them at least once more,
Before the conclusion of what was in store.
“Son, if you have questions, I may have some answers…”
But I did not hear a word after cancer.
A medical marvel, a disease for ages,
Fodder for students and for journal pages,
A fantastical subject destined for the knife.
But this “case of the day” is the rest of my life.
By Tatiana Yeuchyk and Emily Snook
Perspective #1: New Medical Student
On this operative table, I see a man
Who has had fifty six years of life before this moment
Filled with experiences: happy, constructive, challenging
Who has three children, one of whom is overseas,
All of whom are waiting with bated breath by the phone.
I feel the immense responsibility of taking part in his care
The privilege to be privy to one of his most vulnerable moments
He is awake and I speak to him with the utmost respect
Then he is asleep – and I speak about him in the same manner
He has placed his trust in us and that feels invaluable
I will carry that duty throughout the case until he wakes again
And I greet him with a genuine smile once more
To tell him that everything went well, and he did great.
So that he can leave this hospital to live out the rest of his
Fifty sixth year and many more
Perspective #2: Surgical Resident
I need to order that bloodwork
Okay, this is the guy who came into clinic 2 weeks ago with his wife and daughter
Or is this the guy who came into clinic 4 months ago with no one
When this is done I need to check if that CT is back yet
Why is all the equipment at this hospital from the 70s
I hope the staff asks me this question
I hope the staff doesn’t ask me this question
This guy is like my dad’s age
I should call my dad after this and see how he’s doing
He’ll ask how I’m doing
I’ll say fine
I’m tired and I’m doubting myself and I’m tired and I’m fine
But it’s all worth it
For that look on a patient’s face when you tell them it went well
Is this the guy who worked for the transit commission
Or is the guy who retired from being an accountant last year
I can’t forget those discharge summaries
There was a time when I promised myself
That I would stay shiny and sweet and know it all
That was me
And that’s still me
It’s just buried under reminders and outcome stats and memories of all the times
Things haven’t gone as planned
And right now
I don’t have time to find it because
I have to pay attention
“In the operating room,
bordered by its crisp white walls
and identified by the smell of alcohol
and artificial fluorescent light too white and bright it takes a few seconds for our natural human eyes to adjust.
This artificial setting
as a new learner not yet fully indoctrinated to this professional calling.
Where it can feel like our medical institution
does everything it can to make us forget
of the warm body breathing, heart beating, neurons synapsing, blood flowing, and loved ones anticipating
we put drapes around the sterile field to block view of the patient’s face,
we speak in anatomical lingo, so far removed from everyday syntax-
it is not the “womb” but the “uterus” that we must cut through to deliver the fetus;
and it is not a mother, father, daughter, son, partner, teacher, construction worker
lying in front of us
but it’s “patient”.
However, a surgeon must never forget
of the reflection that coexists under those fluorescent haze
that their responsibility is to more than just the uterus or the patient,
but to the human relation
that we must cure sometimes, treat often, and comfort always.”
Today I am presenting a recording I produced of a piece called The Swan. I learned this piece many years ago and in reflection, I thought of the analogy my teacher used to help me learn it. On the surface is the swan (the cello), graceful and smooth. Beneath it, unseen, are its feet (the piano), furiously flapping away. As the current changes and the fury of the feet rise and fall, the swan maintains its composure. This piece holds special meaning to me, as my teacher lost her struggle with cancer several years ago. In playing this, I reflect on the struggle of every cancer patient as they maintain their identities and lives despite the fury of activity and emotion below the surface, often unseen, remaining graceful like the swan. I dedicate this to my late teacher, Grazyna.
Thanks so much,