The I.V. River

Stefano Byer, M3, Class of 2022

I am Mrs. A

Grew up in Kansas City

north, by the river

I held on to life

lifeblood coursing through my veins

through ups, and through downs

Made a family

I love my many grandkids

as grandma loved me

As grandma loved me

I saw her last breath, in pain

with tubes in, tubes out

Now held by my kin

they watch my last breaths, tears drop

with tubes in, tubes out

Came here with a cough

this big building found much more

prognosis now: days

I hold on to life

lifeblood dripping out my veins

few ups, mostly downs

Now memories fade

as my love joins grandma’s

north, down the river



My patient saw herself as her grandmother, spending some of her final days in the hospital. I saw a woman, teetering between abject denial and an enlightened acceptance, negotiating her impending destination.

She was my first patient while in the hospital for my family medicine clerkship. Our week together was full of the “ups and downs.” Ups: a bone biopsy was negative for metastatic lung cancer; downs: she had almost a dozen units of blood transfused over the week to make up for what she’d lost.

One day, her name wasn’t on the floor roster. She had been transferred to the ICU. I kept visiting her, joking and crying—an apt combination.

My role as a medical student is to juggle learning disease processes, management, treatment—from standpoints of molecular, pathophysiological, and systemic issues—while understanding floor dynamics, tailoring our work to different attendings, preparing for standardized exams and patient encounters, etc., but one privileged and exceptional role we can play is in listening.

It is through listening that we can learn why we juggle the aforementioned.

I was reading Mrs. A’s discharge note, the ICU doctor ended it by noting her prognosis as being “days to week.”

We all, whether written or unwritten, have a prognosis – ranging from days to decades. Reflecting on our mortality only informs our reason to live.

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