Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The importance of being there for your patients

Albert Jang, MD
Conditions
June 18, 2019
Share
Tweet
Share

Halfway into my four-week hematology consults elective at the county hospital during my fourth year of medical school, I was surprised that one of my patients was a 25-year-old woman from Romania — exactly my age. This was highly unusual, as most of the patients I had seen on this service were not this young, especially with a malignancy.

What was even more unique was that she had just arrived from Romania, where she had first developed acute lymphoblastic leukemia (ALL) as a young teenager. She was treated, but she relapsed five years later. After subsequent treatment, she relapsed again. And finally, after a bone marrow transplant, she relapsed once more. After she exhausted all treatment options available in Europe, her doctors recommended she try the United States as a final resort.

We met at her hospital bed, with her attentive mother beside her. As I introduced myself to both of them, I immediately saw we could relate. With a young, friendly face and a gentle smile, she answered all the questions I asked with a calm demeanor. Her mother did not understand much English, and she would talk to her in Romanian and interpret for me. She had visited two previous hospitals in the city just one month before I saw her at this county hospital. I was curious why — it turned out she was unable to afford the novel treatments at these hospitals, and hence she came to the county hospital. “My mother and I will fight this to the end,” she vowed.

But the imaging showed widespread involvement in her abdomen. She needed a miracle drug, some of which are currently being manufactured, but the county hospital did not have access to these. We could only give her more traditional chemotherapy. For someone so young who had fought for so long, it was disappointingly not much more than palliative care at this point.

As I continued to pre-round on her in the mornings and provide updates in the afternoons, we noticed much in common. We were both an only child in the family, we loved science and technology, and we were medical students aspiring to become oncologists, merely in different continents. We discussed the process of how medical school and residency worked in our homelands. We looked at photos of her memories from home and medical school on her phone. She taught me how to say some simple phrases in Romanian. Miss Z and her mother always enjoyed these short uplifting conversations while I provided treatment plan updates.

After the hematology rotation ended, I became a sub-intern (sub-I) on the wards service at that county hospital. I continued to visit Miss Z and her mother often. Miss Z and her mother stated they still looked forward to seeing me come say bună (hello), since all of their friends and family were still in Romania. As I was no longer part of her health care team, I could divert our conversations away to more lighthearted topics that could make us smile.

But the chemotherapy-induced complications, with the leukemia not responding, were taking their toll on her. Miss Z and her mother remained steadfastly hopeful that she would still somehow overcome this. The hematologists advised them to return to Romania, to spend her final days with family and friends, but they courageously decided to stay to keep on fighting against the ALL.

Unfortunately, she was eventually moved to the medical intensive care unit. The cancer and opportunistic infections were taking over. I finished my sub-I rotation, but I had one more elective at the county hospital. I would continue to stop by at the end of the workday. She was now too weak to move much or to talk for more than a few minutes. Yet I garnered much respect from her strength to never give up and to remain hopeful, along with her mother’s continued perseverance by her bedside.

One Monday afternoon, I went by her ICU room, and I noticed emptiness. The ICU resident told me she had passed away over the weekend; despite full efforts to resuscitate her, her heart having gone into unrescuable fibrillation. The previous week had been my final la revedere (goodbye). I refused to accept it for a moment, even though we expected this since day one of her admission. I never saw Miss Z or her mother ever again. I could only imagine her mother’s agony while watching her only daughter being futilely resuscitated, as she had never given up hope on her chance of remission.

No lecture in medical school could have ever taught me this, that simply bringing my presence, and a lighthearted conversation topic could brighten up the ICU room. Nor could any lecture prepare me for how to deal with the anguish of this inevitable news, despite what we had learned and experienced for three years in medical school. However, looking back at the positive vibes I was able to bring several times a week to her bedside, this was the ultimate meaningful experience for a medical student. In the environment where learning diseases, performing clinical duties, and studying for standardized exams often take precedence, I was no longer just that one medical student to Miss Z and her mother. I had become a friend supporting her battle to the end.

Albert Jang is an internal medicine resident.

Image credit: Shutterstock.com

Prev

Everyone has value. Even the angry man screaming at you.

June 18, 2019 Kevin 0
…
Next

We care for patients. Why don't we care for ourselves?

June 18, 2019 Kevin 1
…

ADVERTISEMENT

Tagged as: Critical Care, Hospital-Based Medicine

Post navigation

< Previous Post
Everyone has value. Even the angry man screaming at you.
Next Post >
We care for patients. Why don't we care for ourselves?

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Albert Jang, MD

  • Promote a culture of medical school peer education

    Albert Jang, MD

Related Posts

  • Are patients using social media to attack physicians?

    David R. Stukus, MD
  • Hospital administrators thinking about no-cost treatment which really helps patients

    John Corsino, DPT
  • You are abandoning your patients if you are not active on social media

    Pat Rich
  • Cancer patients who want to take unproven supplements

    Marc Braunstein, MD, PhD
  • What charity care patients get big hospital bills

    Jordan Rau
  • A love letter to patients

    Marcie Costello

More in Conditions

  • Why ADHD in women is finally getting the attention it deserves

    Arti Lal, MD
  • Why ruling out sepsis in emergency departments can be lifesaving

    Claude M. D'Antonio, Jr., MD
  • The hidden cost of delaying back surgery

    Gbolahan Okubadejo, MD
  • Venous leak syndrome: a silent challenge faced by all men

    Elliot Justin, MD
  • Make cognitive testing as routine as a blood pressure check

    Joshua Baker and James Jackson, PsyD
  • Reimagining diabetes care with nutrition, not prescriptions

    William Hsu, MD
  • Most Popular

  • Past Week

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • The dreaded question: Do you have boys or girls?

      Pamela Adelstein, MD | Physician
    • A world without antidepressants: What could possibly go wrong?

      Tomi Mitchell, MD | Meds
    • Rethinking patient payments: Why billing is the new frontline of patient care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • The silent crisis hurting pain patients and their doctors

      Kayvan Haddadan, MD | Physician
    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • What happened to real care in health care?

      Christopher H. Foster, PhD, MPA | Policy
    • Are quotas a solution to physician shortages?

      Jacob Murphy | Education
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
  • Recent Posts

    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • Why great patient outcomes don’t protect female doctors from burnout [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why ADHD in women is finally getting the attention it deserves

      Arti Lal, MD | Conditions
    • How a $75 million jet brought down America’s boldest doctor

      Arthur Lazarus, MD, MBA | Physician
    • Why ruling out sepsis in emergency departments can be lifesaving

      Claude M. D'Antonio, Jr., MD | Conditions
    • The hidden cost of delaying back surgery

      Gbolahan Okubadejo, MD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • The dreaded question: Do you have boys or girls?

      Pamela Adelstein, MD | Physician
    • A world without antidepressants: What could possibly go wrong?

      Tomi Mitchell, MD | Meds
    • Rethinking patient payments: Why billing is the new frontline of patient care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • The silent crisis hurting pain patients and their doctors

      Kayvan Haddadan, MD | Physician
    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • What happened to real care in health care?

      Christopher H. Foster, PhD, MPA | Policy
    • Are quotas a solution to physician shortages?

      Jacob Murphy | Education
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
  • Recent Posts

    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • Why great patient outcomes don’t protect female doctors from burnout [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why ADHD in women is finally getting the attention it deserves

      Arti Lal, MD | Conditions
    • How a $75 million jet brought down America’s boldest doctor

      Arthur Lazarus, MD, MBA | Physician
    • Why ruling out sepsis in emergency departments can be lifesaving

      Claude M. D'Antonio, Jr., MD | Conditions
    • The hidden cost of delaying back surgery

      Gbolahan Okubadejo, MD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...