The Five People You Meet in Residency

A gentleman who is admitted with a skin reaction to a new over the counter medication. His skin is covered in blisters, some broken open and oozing, some not, but all incredibly painful to him. You spend a long time at this bedside, methodically categorizing the wounds and cleaning each of them. During these moments, you learn he’s a Brooklyn native; he married his high school sweetheart; he was a Marine in World War II and was present at some of the major battles in the Pacific. You do the math in your head at one point and figure he definitely lied about his age to join the Corps. 

“She’s a spitfire” is the only description of this patient that the attending shares before I go see her. She’s been a patient at the clinic for years, has seen more than enough residents to know if I’m worth my weight in salt, and is beloved by every provider in the building. She’s beaten cancer twice and has managed her diabetes through sheer will and stubbornness (as well as diet and exercise). Her only complaint is a rash on her skin, wrapped around her left wrist where she previously wore a bracelet given to her by her daughter-in-law. Through careful history taking, my initial suspicions of this bracelet causing her rash are confirmed with a decent amount of confidence. She cares less about how I can help treat her rash versus how she’s going to lorde it over her daughter-in-law. She looks positively gleeful. 

He knew it was going to be cancer when he arrived at the ED for evaluation. By the time he got to me on the floor, the series of diagnostic testing we planned out were almost a formality to know the details. He was an emotional stalwart throughout each day, until you asked him about the girl waiting for his phone calls. His childhood friend. The girl who grew up down the block. Back in his life nearly 50 years later. And he was madly in love with her. When he talked about her, his strength in the face of his illness came not from an internal locus but this fight for another person. It’s amazing how much harder someone will fight when it’s for another person. Testing done and a treatment plan in the works, he went home to her and their dogs. 

Sometimes it’s the sad cases that remain the most clear in your mind. This case was a woman in her 60s, reportedly confused and not taking care of herself. I arrived on a Tuesday morning with more questions than answers in the chart in front of me. Often, medicine can make for a good detective story. A personality change in an executive assistant who slowly declined over the months New Yorkers separated from each other in the height of the current pandemic. This story led me to the patient’s family, her primary provider, and an MRI of the brain performed one month prior that delivered stark evidence. The MRI showed volume loss in the temporal areas of the brain, responsible for your emotions, memories and part of the things that make you who you are. A person who from now on will be different from the one you’ve known. 

You get used to communicating through a translator quickly. So far, I’ve had assistance communicating in six different languages over the weeks I’ve been here. But the best moments come when you learn enough of another’s language over the course of care to greet them. I cared for a patient for weeks as she recovered from a stroke and spent much of that time speaking to her family through a translating service. She was non-verbal at first, but as her speech recovered, her family began to understand her attempts to speak their native tongue. One night, I sat for hours on the internet and listened to how to say good morning in their language. The next day, I wished a good morning to my patient in her language. Her eyes went wide, she tried to smile. I found out later through her family she was surprised and happy. When I was in high school, I remember my band director saying that every musician should know how to say “thank you and good night” in the native language of where you’re performing. Every doctor should know how to say “hello, I’ll be taking care of you today” in their patient’s language. Just be sure your pronunciation is correct, because apparently mine could have used some work.