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

I get to be a sorta-kinda-almost doctor now!

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Well, it’s here, that moment we’ve all been waiting for when we are unleashed up onto the hospital wards and allowed to actually take care of patients. No, we’re not doctors yet…but we are 3rd years and with that new title comes the time to close (most of) our books, leave the lecture halls and learn, quite literally, on the job.

This week I began my 6 week rotation on OB/GYN. With my crisp, clean, new white coat with personalized embroidery and blast-from-the-past beeper in hand, I looked like a doctor but sure didn’t feel like one! I would be lying if I didn’t say that I am quite literally terrified of what this year has in store.

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In my past 18 years of education I have mastered the art of having teachers present material to me and then regurgitating it back to them on exams. Classrooms, books, and tests have defined my entire life. But now I have a new set of teachers, my patients, and the final exam is no longer a set of multiple-choice questions, but instead involves the health, well-being, and wholeness of a person.

Today I scrubbed into my first surgery, a vaginal hysterectomy/cystocele & rectocele repair/sling placement, and it was awesome!!! I felt completely incompetent wandering around the halls of the OR suites and mostly just tried to do my best to stay out of everyone’s way. It’s terrifying to feel like I have no clue what I’m doing, but at the same time I know that I’m doing my best to learn fast.

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Despite my best efforts, I know that I will make mistakes. My hope for this year is that I will not lose sight of the fact that each decision I make and the effort that I put into learning during the next 2 years of clinical training will have an impact on countless people either for the good or for the bad. I hope and pray that I will be able to honor the patients that put their lives in my care by learning absolutely everything that they have to teach. I also desire to learn from my residents and attending physicians who have an infinitely more advanced depth of knowledge and experience. I hope that I will not take one moment of this next year for granted for the formative power that it has on my training to be a caring, compassionate, and knowledgeable physician. Despite the apprehension and uncertainty that I feel when thinking about beginning this new year, I am also excited for the new experiences that will come my way!

Saying Goodbye to 2nd Year

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Many people have said that the second year of medical school is the hardest and most grueling year of all.  I’ve heard countless people tell stories of how busy, exhausting, and completely consuming 3rd year is, but it is always followed up by the statement, “But I’d take just about anything, including getting hit by bus, over 2nd year.”

To be completely honest, this was in fact one of the most challenging years of my life for reasons that extended far beyond the rigorous course work that we were faced with each and every day and the ever-looming presence of Step 1 (the exam that makes even other medical licensing exams cry themselves to sleep out of fear).

HOWEVER, I can honestly say that despite the challenges that we faced this year, I will look back on 2nd year with fond memories and a never stronger sense of the presence of God’s guiding hand in my life.  Let me take you through a quick whirlwind tour of what the end of this year was like and what made it so challenging, but I promise there’s a light at the end of the tunnel so keep reading!

From January on, the only thing that 2nd year medical students across America have on their minds is Step 1. This is the mother of all exams; it is 8 hours long and covers all of the content that we have learned in the first 2 years of medical school – anatomy, physiology, cell & molecular biology, immunology, behavioral science, biostatistics, preventive medicine, biochemistry, pharmacology, pathology, pathophysiology, psychiatry, and neurology.  Now this test wouldn’t be such a big deal if it didn’t have so much weight toward which field of medicine we will ultimately be able to enter.  It’s basically the MCAT of residencies and our scores will either make us eligible for competitive specialties like surgery, ophthalmology, radiology, or not.  The saddest part, in my opinion, is that students who may excel in those fields because of their clinical skills and passions may not have the chance to experience those professions because this exam holds so much weight in residency applications.  This was one of the things that I struggled with the most near the end of the year.  I watched countless classmates, who I know will be incredible healers struggle beneath the weight of the pressure that this exam places on students.  The tensions were certainly high and at times the morale was low, however, I can say that the silver lining through it all was learning to trust more in the fact that God has called us to this place to serve in a profession that he will placed us in.  If he has gotten us all this far, then surely he will see us through to the end.

Despite the challenges that we faced during 2nd year, I promised that there would be a light at the end of the tunnel.  Medical school is a process that is so much more than simply learning how to be a doctor; it is a process that challenges people at the very core of who they are and I can honestly say that I have enjoyed that challenge.  I’ve been stretched and forced to grow in ways that I could have never imagined.  I have been required to search for the true reasons why I chose to enter this profession.  I have made the best friends of my life because of the common struggles that we have faced together.  I have been inspired to grow in my walk with God.  I have learned more than I ever thought was possible.  And I have been humbled by the realization that I will never be able to learn everything there is to know about the workings of the human body.  Although the process has been challenging, frustrating, and seemingly impossible at times, I now stand on the other side of the first two years of medical school and can say with confidence that I wouldn’t change anything and would do it all over again in a heartbeat.

 

I would be remiss if I did not take a moment to thank the incredible people who helped make this year both meaningful and enjoyable!:

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My study buddies, Scott and Justin.  We met both years for 2 hours almost every night, 6 hours every Sunday, and ran through at least 45,000 flashcards – about 15,000 cards times a minimum of 3 repetitions. I couldn’t be more blessed or more thankful to have had them by my side through this journey.

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My fellow “Carrelers,” Keri, Krisalyn, Melissa, Stephen, James, David, Linden, Casey (not all of whom are in this picture). I spent my afternoons studying with these wonderful friends in the Study Carrels of Alumni Hall throughout 2nd year.  I have been continuously inspired by each and every one of them and have been spiritually and emotionally uplifted by each of their friendships.

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Dr. Werner, our famed professor of Pathophysiology and the Dean for Medical Student Education to whom we owe our gratitude for continuously inspiring us to never stop learning and to be the absolute best physicians we can possibly be.

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And my classmates, who I love with all my heart!  Coming to Loma Linda and joining these incredible, talented, brilliant, God-fearing, and all-around absolutely wonderful people was the best decision of my life!

When the Going Gets Tough, the Tough Get Carried

Paige, Second Year Medical Student

There are few things in this life that are more valuable than the love and support of friends and family.  I have once again been blessed by this reality in the first few weeks of this New Year.

I am not good at letting people help me.  I like to be in control of every situation, this need comes from a deep-seeded belief that everything that I do must always be perfect.  The fear is that if I let someone do something for me, they won’t do it the way I would and thus it wouldn’t meet my perfectionistic criteria (however skewed those criteria may be).  Fear of failure and the lack of ability to control a situation are in fact my biggest fears in life.  This is why I don’t like swimming in the ocean; the power of the uncontrollable waves literally terrifies me.  This is why I work so hard to get good grades and feel so horrible when things don’t always work out according to plans.  This is why I seldom ask for help, even when I know that it would make my life a million times easier.  And this is also why I struggle in my walk with God, because I am constantly resisting complete submission to His will in my life.

Over the past several years, there have been several situations that I have not been able to control: illness strikes a family member, school becomes overwhelming, relationships go awry.  Each time one of these uncontrollable waves crashes, I am flooded with my deepest fear…that I can’t handle the situation.  It has been times like these when I am thankfully reminded by the loved ones around me that I don’t have to do everything alone, that they can be there to help shoulder the burden and get me through even the toughest situations.

Last week was Week of Renewal on our campus.  It is a week when we have daily chapel services that serve to re-invigorate our spiritual journeys with Christ.  Randy Roberts, senior pastor of the Loma Linda University Church, spoke and shared the story in Mark 2 of the paralytic man that was brought to Jesus by 4 of his friends.  He shared the story to illustrate the importance of having friends who would be willing to go to any length to support you in your times of greatest need.  I resonated with this story and thought about the people in my life who have recently “lowered me through the roof to Jesus.”  Phone calls came from my sister, my Aunt, and my cousins, loving hugs and wise words came from my parents and my grandpa, and I have had several encouraging, spiritually uplifting conversations with friends.  All of these incredible people have shown me that sometimes it takes having a wave knock us off our feet to help us learn that we can let others carry us to Jesus so that He can then say, “take up your mat and walk.”

2nd Year…A Pause to Remember a Sacred Oath

Paige, Second Year Medical StudentAs is evident by the fact that this is my first blog post since the summer before year 2 of medical school commenced, 2nd year is BUSY!  Last year, we heard the 2nd year students grumble about how much they missed 1st year and how busy and completely consuming the ominous 2nd year was.  However, as a 1st year student, it was hard to believe that things could really be that much more difficult.  Little did I know, all the grumblings about 2nd year being one of the most difficult years of my academic life would indeed be indeed prove to be true.  In addition to a heavy academic load that includes: Pathophysiology, Pathology, Microbiology, Pharmacology, Neurology, Psychopathology, Preventive Medicine, and Biochemistry there are the additional requirements of labs, self-study lectures, continuity clinics, medical simulation labs, clinical skills OSCEs, and the ever-looming Step 1 test that will basically determine which residency programs we will be eligible for upon completing medical school.  Throw in extracurricular service activities, time to eat (cooking optional), exercise, spending time with loved ones, and devoting time to building a relationship with God and needless to say, there are never enough hours in the day to accomplish everything with the type of perfectionistic approach that we medical students desire.

If you have read my blog posts prior to this, you must be thinking, “Wow, this girl has suddenly become quite the Debbie Downer!”  I hope that you will continue to read however, because it has been this process of fully realizing the difficulty and challenges of medicine that has shown me even more of the immense value of this profession that I have chosen to pursue.  Moreover, it has shown me that even when things get tough—which they do—if you have the right support system, priorities, and determination, it can be done!

As I sit here on my last weekend of Christmas break and reflect over the past few months since beginning this year, I can honestly say that there have been many times, in fact, the majority of times when I have not had my priorities straight.  Relationships with family, friends, and God have all been stretched to the limit as I have put school again and again at the top of my priority list.  I have always had to work hard in school, but I have always been up for the challenge and have always truly enjoyed the process of learning.  Yet, at the beginning of this Christmas break I was exhausted, burnt out, and dreading the thought of once again immersing myself in the firehose of information that never gets turned off.  As far as I was concerned, the challenge was starting to look like it was a bit more than I could handle.

However, God showed me once again in a most unsuspecting way that He was the one guiding and sustaining me down this career path.  On New Year’s Eve my family had the opportunity to visit the Reagan National Library near my sister’s house in Ventura, California.  There are thousands of quotes scattered throughout this exhibition of President Reagan’s life story and accomplishments, and it would take days to read all of the information provided about the life of this incredible man.  We only had a few hours to walk the museum so we casually perused the information, taking note of just the main highlights.  One quote, tucked away in the volumes of information, stood out to me immediately.  It was spoken by President Reagan on his inauguration day and read, “I consider the trust that you have placed in me sacred, and I give you my sacred oath that I will do my utmost to justify your faith.”

Upon reading this quote, I was immediately struck with awe at the relevance it had in my own life.  It reminded me of that day a year and half ago when I recited a sacred oath “To Make Man Whole” and received a white coat that would signify the sacred trust of many patients that I would soon encounter.  I have no doubt that God used this quote to remind me of the reasons why I am currently working so diligently to conquer this difficult 2nd year of medical school.  As I look to begin this last 6 months of year 2, I am reinvigorated by this reminder of the sacred trust that has been placed in us as healthcare providers, and our sacred oath to be the best physicians that we can be in order to justify the faith that our future patients will have in us.