To maintain the privacy of our first patient we have changed their name and our names.
The First Patient Program, as most of us know, is a program that matches a pair of first year medical students to a real patient who volunteers their time in order to grow our understanding of the patient experience. Through this program, you attend your patient’s medical appointments and get to know your patient as a person. If we recall correctly, the program requirement was something like a minimum of two appointment visits with your first patient.
In the early stages of the year, we had already heard of struggles coming from our classmates regarding reaching patients and having to travel far and wide to attend appointments. At the time, we thought we were lucky because our patient had regularly scheduled treatments at the hospital, which meant that we could visit them whenever we wanted, and just a few steps from the school. What started as fulfilling requirements quickly blossomed into a relationship that we don’t think either party expected. Because we always knew when and where our patient would be for their treatment, we ended up visiting them somewhere between weekly and biweekly for the year.
Our interactions with Stanley consisted of conversations in the waiting room which transitioned into conversations in the treatment room. Stanley had almost everything go wrong with him medically, but his approach and outlook on life was everything right. Stanley shared a lot with us; first his medical history, his triumphs and pitfalls with the healthcare system, his personal opinions on just about anything, and most importantly, his personal life. He shared stories from his childhood, his hobbies, his family life, and his weekend plans. We quickly learned that Stanley was very talented with woodworking and creating realistic Halloween costumes. (He once tried to create an Ironman costume with a working core).
We quickly learned and saw how his chronic illness stood in the way of many aspects of his life. But Stanley wasn’t the type of person to let his illness control his life. He would happily chat away in his usual sarcastic demeanor, all while several needles and tubes traveled from his arms to the machine beside him.
Stanley was very opinionated about the care he received. But he was fair as well. He clearly remembered all of the interactions he had with his physicians over the years. Our teachers often reiterated that “patients have excellent memories”, but this lesson meant much more coming from our patient. Stanley was sometimes critical of physicians who had dismissed him or treated him poorly, but also effusive in his praise of his care providers who took the time to listen to him and show him a little bit of empathy.
We only really knew Stanley for about a year - maybe less, but he taught us so much.
One of the things we remember most clearly about Stanley, is how his routine coffee or tea poured by the circulating volunteer would remain untouched for the entire time we were visiting. We’d often question why he wasn’t drinking it and encourage him to drink his beverage before it got cold. His answer was simple: “I don’t want to be impolite - if you guys don’t have a drink, I don’t want to drink this and make you feel thirsty!” This was coming from the man who already had to restrict his fluid intake for the day for his treatment. From then on, we’d each bring a beverage and so we could drink with Stanley.
Stanley also had a sharp memory. He was always cautious and respectful of our time, reminding us that it was time for us to go to our intramurals, home to make dinner, study, whatever.
One of the first things Stanley told us was to stay the way we were - stay compassionate, caring, and curious about your patients. Take the time to talk to them and listen. He found that the best doctors not only listened to what he had to share regarding his medical history, but could take a step back because they knew he was the expert on his illness, not them.
It’s easy to forget the human side of medicine during the first two years of school. The relationship that we had built with our patient helped us to stay grounded and we learned how it feels to navigate the healthcare system with a chronic disease and a busy schedule.
We found out that Stanley suddenly passed away a few months ago. They say that your first patient death is something you will never forget. Stanley was our first patient, maybe not in the literal sense, but he was and will always be remembered as a kind and thoughtful soul with an unapologetically stark sense of humour. Stanley, thank you for volunteering your time so that we could learn from you.
We will never forget you.
A poem by Alex Morra, Meds '21
Your soul begging to be pried,
Your brain - terrified.
Her stare exudes intensity,
Piercing through my walls,
My insecurities tumbling,
No barrier left to climb.
My heart valves,
Rusted from decades of tears,
Surge with feeling,
Lubricated by emotions,
I am open.
Nicole Krysa, Meds '22
You may not know this, but you can actually wear your heart in one of two places. In the usual spot, buried deep in your chest, or right out in the open on your sleeve. If you are familiar with this latter practice, then you have likely observed that it is often discouraged. While I seek to make a case for wearing your heart on your sleeve, I will concede that it is not without reason that those who are invested in your well-being may caution against it.
The most obvious cause for concern is that when you remove your heart from the protective cage of your ribs, it becomes highly vulnerable to insult. This is frightening for certain, and I would acquiesce that your heart will inevitably experience some bruises (at the very least) when it is donned in this way. However, removing your heart from constraints also allows it to grow to its maximum capacity. When your heart is able to flourish and expand, those demarcations on its surface, the character-building nicks and bruises experienced previously, seem to shrink in comparison. Some insults might be so penetrative that they never fully fade. However, with a heart so big and robust, you may just find that you have a newfound strength to cope with, acknowledge, and conquer those former stresses.
On the other hand, society informs us that we should not be so forthcoming with our hearts. Many feel that if we are too frivolous with the information that we display, it can be utilized in a negative way to harm or humiliate us. This is yet another reason why the practice of wearing your heart on your sleeve is not well-advertised and certainly not frequently advocated for. I have observed, however, that if you are forthcoming with your feelings and experiences, and do not perceive them as ill-advised or shameful, others will also lose the ability to see them as such. Although this notion may be foreign or frightening to you, I invite you to wholeheartedly try it. After all, words can only be utilized as weaponry if you endow them with that power.
Another great benefit of wearing your heart right out in the open is that with time, others will feel that they can do the same. You might feel that it is flashy or obnoxious to be so brazen about how you wear your heart, but it is actually one of the strongest and most inspiring things that one can do. Watching you liberate yourself to be free with your emotions will not put off others as you might believe. Rather, it will empower them to do the same. As with any great change, it is difficult to be one of the revolutionaries, and you will certainly be subject to scrutiny and criticism long before widespread acceptance occurs. However, once you, and perhaps a few other bold individuals start to proudly put your hearts out on display, it will only seem natural for more to do the same. Eventually, people will forget that this was not always the way things were. You can see where this will lead, I am certain. With so many hearts displayed so boldly, the pool from which to give and receive love becomes infinitely larger and more accessible. Not only are you more readily able to give yourself emotionally to those who need it (and everybody does from time-to-time), but additionally, when you are in need of support, you may just find that you do not have to look far at all to acquire it.
Lastly, I encourage you to take your fragile heart out from time-to-time and bravely tack it to your sleeve for one vital reason. This is especially imperative as you move through your journey in this trying yet noble career path. In the coming weeks, months, and years, you will be challenged in ways that you never have before, and your innate ability to offer empathy and compassion will be threatened many times over.
Perhaps the most important reason of all to wear your heart on your sleeve is so that you can catch a glimpse of it from time-to-time and remember that it is there.
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