The Other Side of the Curtain

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On Friday, August 1, my dad was admitted to Loma Linda University Medical Center on Unit 9300. Hospitalizations such as this had been somewhat of a routine since his initial diagnosis of Stage IV metastatic colon cancer four and half years ago. However, this hospitalization was different for many reasons. For one, his body was beginning to show signs of giving up the battle that he had been fighting so valiantly for so long. The previous day, he had been told that the myelodysplasia that had resulted from continuously stimulating his bone marrow to produce more white blood cells, platelets, and red blood cells had progressed to full-blown leukemia. He was requiring several platelet and RBC transfusions each week and he was admitted to hospital this time for uncontrolled bleeding requiring platelet transfusion and unexplained spiking fevers. Despite the seemingly more and more grim prognosis, we remained hopeful that dad would pull through this just as he had with his many previous hospitalizations.

The other aspect that made this hospitalization different from all the rest was the fact that I had just begun my 3rd year of medical school and had completed a rotation on this unit just a few weeks prior during my time on the Gynecological Oncology service. Moreover, many of classmates were now rotating through the halls of 9300 and were even responsible for rounding on my father each day while on their Internal Medicine rotations. Each day I would dodge glances from residents, attending physicians, and students that may recognize me as I entered the hospital as a visitor instead of as a medical student. For months, I had been the one in the white coat standing on the outside of the curtain, now I was the sitting at a bedside on the inside of the curtain experiencing the same sights, sounds, places, people, and decisions but from an entirely new perspective.

As time progressed, it became apparent that my dad’s condition was in fact much worse than we had imagined and that we may be faced with saying goodbye sooner than we had hoped. We made the decision to take my dad home on Hospice on Friday, August 8 and merely three days later he passed away peacefully surrounded by family on Monday, August 11.

I tell this story of my dad’s illness and my experiences that went along with it because this is medical student blog. And whether I liked it or not, I was a medical student and a patient’s family member at the same time throughout this process. Moreover, I tell this story because so many of the subsequent events that occurred speak such volumes regarding what Loma Linda University is all about and how I can now personally attest to the fact that Loma Linda holds true to its mission “To Make Man Whole” when surveyed from both sides of the curtain.

 

The Patient Side of the Curtain

There is nothing more meaningful to a patient and family members sitting in a hospital than being treated by a team of people who truly care. Doctors Howard, Moore, and Wei were 3 such physicians who stuck out in my mind as physicians who truly emulate the mission of Loma Linda to treat the whole person. Dr. Howard was my dad’s personal oncologist and he took several evenings of his own time after clinic to come and visit us in the hospital. He spent hours with us discussing our options and ensuring that we knew that we would be taken care of until the very end. Dr. Moore has mastered the art of comforting patients and caring for patients during the end of life as a palliative care specialist. She worked with our family for several days to ensure that we could take our dad home on hospice so that he could be comfortable during his final days. Dr. Wei is a Senior Resident on the internal medicine service who took the time to pray with our family several times during our hospital visit. Perhaps the most touching moment of all for me was when he and his entire team visited our family during the memorial service and expressed his condolences for our loss.

At a certain point in the progression of my dad’s illness, we knew that he would likely succumb to the cumulative toll that his disease had taken on his body. These physicians never lost sight of the fact that there is always something more that a medical team can do to ensure the wholeness of their patients and families. They dedicated their time, prayers, and support until the very end of my dad’s life and then extended their love to us as a family after his passing. I cannot think of three more compassionate, dedicated, and Christ-like physicians and I am so grateful for everything that they did for our family.

 

The Medical Student Side of the Curtain

As I’ve mentioned in previous blogs, medical school is hard. Adding on the additional stress of a situation such as this was, at times, unbearable. Prior to this hospitalization I had not shared the reality of my dad’s illness with more than a few of my closest classmates and friends, I didn’t want to burden them with my problems. However, now that I knew so many people in the hospital because of my clinical rotations and because of the severity of my father’s illness, I finally opened up to my classmates and the School of Medicine Dean’s Office about my situation. The response that I received was amazing to say the least.

I have never in my life felt more completely surrounded by support and love. The Dean’s Office ensured me that I could take as much time as I needed away from school to work things out with my family. My classmates sent me Bible verses, encouraging words, and offered prayers for my family seemingly continuously. Several of my classmates provided a moving special music during the memorial service and many classmates and members of the Dean’s Office attended the service in order to support me through this difficult time. My family and I were completely astounded by the tremendous out-pouring of support that we received from the School of Medicine during this time and I can only say that I am so incredibly blessed to be in a place that cares for its students in such a profound way.

My last 2 weeks have been spent on the Internal Medicine team at LLUMC; the same team that took care of my dad during his final hospitalization. I now stand, once again, on the outside of the curtain, knowing numbers, lab values, and diagnoses but only catching small glimpses into the private lives of my patients who anxiously await any news about their health and well-being. During my first week on this service, I was faced once again with the painful realities of some of the experiences that my family went through. I’ve been a part of a team who diagnosed a man with advanced cancer and watched as his world and his family’s world came crashing to a sudden halt as those words escaped our attending physician’s lips. I’ve held back tears watching patients struggle through illness, treatment, and even death. I’ve been shaken to my core by these experiences, been pushed to the limits of my emotional and mental capacity, and have been left wishing that there was something more that I could do to ease my patients suffering and my own.

And yet, as difficult as this all has been, these challenges and raw emotions have been a blessing because they have taught me so much. I have a whole new understanding of what it means to stand on both sides of a hospital curtain. I have had the opportunity to be comforted and be the comforter. I’ve had the chance to be the one who is prayed for and to be the one who is praying. And through it all, I’ve seen the hope, assurance, and peace that only a faith in God can bring during the most difficult moments that we face in this life.

 

I pray that you’ve never had to experience both sides of a hospital curtain, but the chances are that many of you reading this blog have already been or will be faced with that reality. I hope that from the patient side you will be able to experience the same healing and wholeness that I was able to appreciate from the team that cared for my dad. And I hope that from the physician side you will never forget the power that you have to bring your patients hope and point them toward the greatest physician of all.

 

My dad's photo in the halls of LLUMC as a part of the "I Am" campaign

My dad’s photo in the halls of LLUMC as a part of the “I Am” campaign

Family Medicine Wards

Adam K., First Year Medical Student

As I sit down to write this post, my head is spinning with new anatomical terms. For some reason “external occipital protuberance” is stuck in my mind and my mental voice continues to chant all those syllables. When I try to sleep, I think of transverse foramen and sternocleidomastoids. It’s bizarre, but that’s med school.

The first week of classes has been a brutal initiation, with anatomy composing the bulk of the suffering. Nothing is too complicated; it’s just the sheer volume. You thought you were ready for this, but after the first lecture you realized that you were NOT, and that the overwhelmed, my-head-is-on-fire feeling that you can’t shake is probably not going to leave anytime soon. It’s tough, it’s draining, but I absolutely love it.

One thing keeping me focused through all this, and something that I am very glad is part of the Loma Linda curriculum, is the ward experience we had in the two weeks prior to the start of classes. The goal of wards is simply to expose you to a (possibly new) discipline, see how a medical team works, and experience some patient interaction before the blitz of textbook material begins. My previous experience was mainly in pathology, with a little urology sprinkled in there somewhere, so when I discovered I was assigned to a family medicine inpatient ward, I had no idea what to expect.

The family medicine team consisted of another first year med student, two interns, two residents, an attending physician, and myself. The second week we switched attendings, and added a fourth year med student and another intern. I could tell right away that I was going to get along with them. They were earnest, had a great sense of humor, and worked well with each other. The first day we spent the first ten minutes of rounds discussing our favorite restaurants in the area. The next day, recent vacations.

The family medicine team

The family medicine team

At about 9 AM every morning, the team would go through rounds, either at the table in the call room, or walking rounds in the ward. One thing that surprised me was the amount of interrupting concern. The phones were constantly ringing with different patient issues. Typically we had about a dozen patients in the ward, and after going through each in detail, the whole team would visit the patients.

I won’t go into detail about most of the things I soaked up in those two weeks (including my newfound love of family medicine—a later post, perhaps), but I do want to discuss the Love Rounds. Each Thursday afternoon, the family medicine team visits a patient to talk with them about their personal and spiritual life. The woman we visited was a regular patient with diverse medical issues, and someone the team thought they knew fairly well. In the course of a forty-minute conversation, we learned the source of her anxiety (the traumatic death of her father and the fear that she would die and leave her kids behind), her earnest but unformed belief in God, and other personal details. It was amazing to see the more intimate side of medicine. The intern in charge of her care said his eyes were opened and that he now understood her situation much better.

That’s what this is about, taking care of the whole person, and as my mind burns with anatomy, I can remember that there is a higher purpose to what we are doing.

Week One Done and Then Some!

Rubi, First Year Medical Student

How time flies!!! I know that is pretty cliché but the truth is it is hard to believe that my first week of real classes has come and gone. I’m not sure how it worked out that after our first week we would also be rewarded with a long weekend but I am so grateful.

One thing about me is that I love schedules and routines. Well, needless to say, my predictable schedule is as far away as summer break. Each day brings different classes, labs, religion class, or small group sessions. Though quite different I will admit that I do like the “newness” of each day. Every day brings something different and that adds some excitement because once all the classes are finished, what follows is always the same: studying, studying and more studying!

That’s enough about that though, now I want to share what I did on my long weekend (yes, besides study). Having done the Biomedical Sciences Program last year, I noticed that my life tends to revolve around my Sabbath. The flurry of the week tends to become a blur and I started living around that one special day. There were always plans for the Sabbath as it was what I waited for all week. That’s not to say I did not enjoy my classes and learning new material, but one always finds comfort in a “Refuge” from the busyness.

That being said, Labor Day weekend was no different. The initial plan was to go to SWYC and a whole caravan of us headed out Sabbath morning. Well, unfortunately, there was “no more room at the inn.” What did we do? Well, we hadn’t driven almost an hour and a half to turn around and go home so we stopped by Lake Hemet which just happened to be down the street! We joined another group who had the same idea as us, and before we knew it we had a whole service taking place! Many other people joined and it was such a blessing to meet God by the beautiful lake! Since I was so caught up in the moment I forgot to take pictures but a friend gave me a couple he took so here they are!

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As I was standing with my feet in the lake, I was just amazed at the beauty of the water, the tall, green trees surrounding it as if hugging the lake and the bright sun that made the water sparkle. I was left in awe as to just how it was that God had led me to that place. Not just the lake but to Loma Linda and specifically to the School of Medicine. It’s a story that I will be sharing a bit throughout the year, but for now let’s just say this was not in my vision for my life but God has a way of making things happen and in the end, His way is always best!

Even though the White Coat Ceremony has already come and gone, that experience is still quite fresh in my mind and so pivotal to my story that I can’t leave it out! Last year, especially when times got so stressful and I was just so tired I imagined myself on that stage, receiving that coveted possession with my proud family watching. That is what got me through when nothing else could motivate me! It truly was a dream come true. I remember sitting next to my Biomed friends, holding back tears the entire time. When my name was called, I walked up to the stage, handed my coat to the doctor, and turned to face my parents. The look of pride and the tears of joy on their faces was so overwhelming! That night was as much for them, if not more so, as it was for me. I smiled, put on my white coat and walked off the stage realizing that not only was it “me” starting this new journey but it would be “us.” My parents have been an incredible support for me and, in addition to my awesome God, are the reason I have made it to this point. Theirs is an incredible story and I just have to share a picture of me with them and of course my nephew, Angel, since I’m sure I will be sharing part of their story as well!

 

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From the OR to the Classroom

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After two weeks of great clinical experience, the real work now begins.  The classroom and library are now my homes.  But before the week gets really busy I want to share a bit about my brief time in anesthesiology and orthopedic surgery.  In short, it was great.  Far beyond my expectations.  Instead of standing in the corner and silently observing I got to make incisions, practice suturing, assist in the removal of rods and screws, feed medications into IV lines, and of course ask a lot of questions.  Such an excellent way to start this adventure.  I am really looking forward to the four week clinical rotation we will have at the end of the year.

Since today is the first day of classroom fun I want to mention the extensive support provided by those who have come before us.  They have shared many tips and strategies that I have no doubt will be very, very helpful over the next two years.  An unexpected bonus of starting the year with the clinical rotation is that you have two weeks to become familiar with these tools instead of trying to do it on top of the daily study load.

That’s all for now, have a great week!