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
***
Reflection:
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.
Med Intima 