been a bit gruff, even mean, with previous medical students. I was determined to get beyond his "difficult" personality and find the cause of his ascites. But luckily for me, he was determined to remind me of something I knew but had forgotten since being in medical school.
"Mr. Webber, can you describe to me what has happened since your previous admission?" I asked.
His response came in the form of another question: "What is that symbol on the bottom of your tie?"
"It's the Naval Academy crest." I replied quickly and immediately asked another question: "How soon after you went home did your ascites recur?"
Ignoring my question, he asked another: "Are you a Navy man, Mr. Cronin, because I served 21 years in the Navy, in both the Atlantic and Pacific fleets."
"I am in the Navy. Thank you for your service. Are you in any pain?" I kept my responses to his questions short, hoping to deliver the message that I was in the room to talk about his health, not about the Navy.
"The Navy is where I met my beautiful wife, sitting there," he said. He was just as persistent at ignoring my questions as I was at deflecting his.
After a few more rounds of the two of us talking past each other, his persistence won out. I stopped resisting and spent some time hearing about the ships that he had served on and the deployments that he had completed. What I learned was that Mr. Webber was not mean but very funny, that he was not gruff but scared. He was worried about the cause of his recurrent ascites, about the strain his condition was putting on his wife, about whether it might shorten his life.
I spent the next few days investigating
I spent the next few days investigating all the causes and possible treatments for ascites. But even more important, I spent time at the end of each day getting to know Mr. Webber better. We traded sea stories. I shared with him everything I was learning about his condition. He and his wife told me how they had met. As I invested time in him, he invested time in me. —Andy Cronin '09
all the causes and possible treatments for ascites. But even more important, I spent time at the end of each day getting to know Mr. Webber better. We traded sea stories. I shared with him everything I was learning about his condition and why it was difficult to pin down a specific cause. He and his wife told me about how they had met and emphasized the importance of their relationship in each of their lives. As I invested time in him, he invested time in me. He shared insights from a patient's perspective about what makes a good doctor. He even requested that I perform his paracentesis—a procedure to draw out the built-up fluid through a thin, hollow needle—knowing full well that I had never performed one before. I thanked Mr. Webber for the experience, and he told me it was an honor to be a part of my education.
Though we continued to run lab tests and to consult with experts in gastroenterology, we were unable to determine the underlying cause of his ascites. We discharged him with a plan for frequent follow-up visits, hoping that closer management of his condition would avoid any more long hospitalizations. The
day he left for home, one of his last comments to me was that he'd love to have served in the Navy with me and to have seen me in my uniform.
Although I had been unable to identify a cause or cure for his problem, this latter request was one I could fulfill. On Mr. Webber's first follow-up visit, I surprised him by wearing my dress Navy uniform. I even had someone take a picture of the two of us together. I had one print developed for myself, to serve as a reminder of the lesson I'd learned from Mr. Webber, and I sent another copy to him, together with a note of thanks. I thanked him for reminding me why I had gone into medicine. I thanked him for reminding me that the reason for all my science classes was so I could better serve my patients, and that in that context studying was not a chore but a resource I would draw on again and again. And, finally, I thanked him for reminding me that even though I may not always have a cure, I can always care for the patient.
By Andrea Pearson, M.D.
Annie Pearson graduated from Dartmouth Medical School in 2008 and is currently a first-year resident in internal medicine at the University of Massachusetts's Saint Vincent Hospital. She did her undergraduate work at Holy Cross, majoring in psychology.
The very first patient I met upon starting my third-year clinical rotations was my most memorable one, for many reasons.
I'd drawn surgery as my first rotation. The night before the eight-week stint started, my mind tried desperately to prepare as I double-, triple-, and quadruple-checked my bag to ensure that I was carrying everything I would need: Lunch, check. Surgery Rapid Review, check. Extra hair elastics and barrettes, check. Stethoscope, check.