Rachel Stetson, M3, Class of 2024
It’s 6:45 a.m. I show up early to my shift to get reports and collect vitals on my patients before the interruption of breakfast trays and morning rounds.
The summarized information I carry with me as I approach room 209: “72-year-old woman, here for GI bleed. Colonoscopy expected tomorrow, night shift will start bowel prep. Rheumatoid arthritis. Encourage Q2 turns. 2x assist, gait belt/walker, requires assistive devices to eat. Dysphagia diet II. Q4 vitals. Uses bedside commode. Expected discharge in one day if scope is benign.”
And the undocumented background given by nightshift: “‘Mrs. RA’ is VERY particular during mealtimes. You MUST cut everything up and put her “squishy” handle on the silverware. Her straw must point to her, and the drink must be on the right side. She has failed getting through bowel prep twice—so be encouraging today. Also, she yelps a lot when you try to move her, she’ll want to refuse Q2 turns. Her daughters will come in a lot. She likes a lot of blankets. Let’s just say she’ll hit her call button a lot.”
I filter both the necessary medical information combined with the “unofficial background” as I think about impending interactions with Mrs. RA. Dreading the call lights and wanting to get through my first set of vitals, I venture off to morning rounds.
I start my rounds off with room 209, the door creaks open loudly, making a rude awakening for a sleeping patient. From the door, the bed appears empty, but as I approach, I realize Mrs. RA is no larger than three hospital issued pillows, tucked beneath a heap of blankets. She whips her rail-thin arm out from her covers, ready for the blood pressure cuff I have for her. As I take her blood pressure, I notice her fingers are bent lent like the firs of a Christmas tree that has been boxed up all winter long. I can’t help but wonder how she is able to write, use a cellphone, let alone grasp a fork. This was my first encounter with rheumatoid arthritis.
After assisting other patients, 11am vitals roll around and I head back to room 209, still balancing the contrast of the petite frail woman I had met that morning with the “needy” description given in the report.
The door creaks open again, and I find Mrs. RA sat-up in bed, having been repositioned by the physical therapists, with her overbed table before her and a smile from ear to ear. This time she is eager to chat—“How is your day going?” “How long have you worked here?” “You look so young, how old are you?”—but I am distracted by the pail of colored pencils and the intricate coloring book before her. Pages on pages of perfected designs with elaborate line work lay before me.
How does this woman, with fingers as stiff as boards, grip a pencil, let alone color inside the lines, to create the skillful artwork before me?
By the end of the day, I realized I had learned just as much about her passion for creating beauty as I had about her diagnosis. I witnessed true persistence to enjoy life and what it means to be intentional in spending time with family. It turned out that I made more trips to her room than she had pushed for on the call light. Between serving other patients and on my breaks, I was drawn back to her room, eager to learn more about her life and experiences.
Though I was supposed to be serving her, I found she instead taught me to live beyond my assumptions. She proved that our patients can’t always be captured on a chart.
I had presumed the characteristics of Mrs. RA by the report I was given. I had assumed her capabilities by the diagnosis I was told. But she is not only a defined condition. She is not only a patient. Through her sharing of passion, I saw her humanity. I saw that she was more than statements on a patient report, more than numbers on a vitals chart, more than her physical capabilities.
She is a person, with a heartbeat, still creating, and enjoying life. Persisting beyond the limitations we placed on her. Living beyond what our textbooks had defined for her.
I left that day choosing to see beyond her diagnosis.
(Disclaimer: The above recounts an experience during my time as a certified nursing assistant. The essay was written recently based on the Hope Babette Tang Humanism in Healthcare Essay prompt during my second year of medical school—drawing me back to reflect on that profound experience.)