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 gravity of difficult questions

Allison Ong
Conditions
June 15, 2022
Share
Tweet
Share

“I don’t want to be alive anymore.”

My friend Margot was despondent. Her lips quivered. Her eyes, normally the shape of almonds, folded themselves into little triangles when she cried. This kind and gentle woman of 62 years – my neighbor –  was undeniably at her lowest point. I was sharing a couch with her during my junior year of college as her composure crumpled before me.

I first met Margot when her companion, a dog named Sofie, ran loose, and I helped reunite them. When I saw her – a slight woman with wispy brown hair, empty leash in her hand – she clutched Sofie like her own daughter. “She is all I have, all I have,” she cried. Her apartment was small, dark, and brimming with unopened cardboard boxes. The scent of wine lingered in the air. Our new friend needed some help adjusting to Los Angeles.

Following a nasty divorce, Margot felt lost. I listened to her stories about growing up in France and, as the years passed, she bore witness to the realization that I wanted to go to medical school. I took her to urgent care, veterinary appointments, the visa office downtown. She showed me Jewish music. She met my family. She was a brilliant woman.

But many of her problems – immigration, depression, drinking – were not easy fixes. I was scared of her trauma. Scared of setting off her tears. Scared of probing too deeply about her son, who she desperately messaged on the days she felt saddest, receiving only silence.

Three years later as I prepared for my psychiatry rotation, I remembered being the college student who realized she bit off more than she could chew. I was nervous. Some say the more intimate medical specialties are surgery and psychiatry. Surgery, my third rotation, struck me as concrete and precise in its handling of the body. I retracted bowel, closed skin, felt a woman’s pulsating aorta and spoke to her the next morning. Intimate indeed! By comparison, psychiatry seemed abstract and imprecise, like surgery in the dark. I imagined myself striking exposed nerves without my knowledge: saying the wrong thing, offending someone, hearing my voice echo back at me from caverns I was too afraid to enter.

My first encounter on child psychiatry was a girl who swallowed a handful of pills. I nearly shrunk into the curtains trying not to betray how terrified I was by a psychiatric interview. Yet I saw how confidently and compassionately our psychiatrists handled her story, responded to her emotions, and drew out the pertinent aspects of the history allowing them to identify what she needed most.

These were the conversations I wanted to learn about.

***

Navajo surgeon Lori Arviso Alvord wrote in The Scalpel and the Silver Bear, “the scalpel is used to bridge worlds.” Dr. Alvord carved pathways between Navajo culture and white culture, between air outside the body and air within the body. She practiced surgery in the concept of hozho, walking in beauty. The surgeon in harmony with her team, her patient, and her world: hozho.

I imagined psychiatrists wielding a scalpel of their own. One of my first patients was a slim, pale girl hospitalized for a serious infection. Her history included autism spectrum disorder, depression, anxiety, and PTSD. She was extremely intelligent, with a quick and dry sense of humor. But she became nearly unresponsive when probed about her family. I wanted to build a bridge.

My favorite professors challenge us to hone our observational skills. Between images of chest X-rays and angry rashes, one professor presented an ordinary photo of our campus and heightened our awareness to a hummingbird nest (with babies) hidden expertly in the beams of a light fixture. Another professor had us analyze paintings exploring pain. The artist in me had always wanted to sharpen this awareness in a medical lens. So in my patient’s room, I let my gaze wander: over a monthlong stay, what had she filled her space with?

Books for learning Japanese, colored pencils, a Pokemon plushie … so she played Pokemon, which I happened to be familiar with. I have one more question for you, I said at the end of our first meeting. Who was your starter Pokemon from the Sinnoh region?

Her eyes lit up.

ADVERTISEMENT

Although this girl struggled with her own emotions, she excelled at crafting stories for animated characters. So I challenged her: each day, she chose a Pokemon that represented her mood. At first, every Pokemon she chose was “tired.” But after a couple of sessions she picked one that looked “sad,” and we explored that. When she meditated with the help of my classmate, she shared a peaceful memory with her family.

She was also a gentle introduction to the many visits I took in the ED for suicidal ideation. I pictured myself on the couch next to Margot, afraid, and then reminded myself how far I’d come. My fellow coached me, “when you stay calm and confident, your patients will open up seeing that you can handle it.” So I took my deep breaths. I learned how to let the patient drive their story and tried my best to find what they needed next, even if it was a million things they really needed. There was no rush, no race. Our goal was to build bridges and invite people across.

***

Margot returned to France, looking to turn a new page in her story. There’s still so much sadness in her I don’t know how to handle, but if there’s anything medicine has taught me yet, it’s that we will learn and grow throughout our entire lives. Part of that learning includes setting boundaries.

It’s a rite of passage for students to see every field and challenge themselves into the doctor they want to be. The gravity of difficult questions stays with me as I continue to ask them in different forms, in different settings, to different people.

But what is gravity if not grounding us with our patients, with ourselves?

Allison Ong is a medical student.

Image credit: Shutterstock.com

Prev

How long will it take to address clinical inertia in T2DM? [PODCAST]

June 14, 2022 Kevin 0
…
Next

Fresh prescriptions: Looking for the twinkling lights

June 15, 2022 Kevin 0
…

Tagged as: Emergency Medicine

Post navigation

< Previous Post
How long will it take to address clinical inertia in T2DM? [PODCAST]
Next Post >
Fresh prescriptions: Looking for the twinkling lights

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

Related Posts

  • She sees difficult patients, but is a difficult patient herself

    Kristin Puhl, MD
  • Many questions remain about medical marijuana

    Steven Reznick, MD
  • Questions about pharma pricing and marketing

    Martha Rosenberg
  • Primary care faces a very difficult winter

    Ken Terry
  • We must ask patients obvious questions

    Weijie Violet Lin
  • 10 tips for delivering difficult pediatric diagnoses

    Laura Spiegel

More in Conditions

  • A speech pathologist’s key to better, safer patient care

    Adena Dacy, CCC-SLP
  • How collaboration saved my life from a rare disease doctors couldn’t diagnose

    Tami Burdick
  • Why your emotions are your greatest compass in therapy and life

    Maire Daugharty, MD
  • Patients are not waiting: What MCDA twin parents teach us about shared decision-making

    Stephanie Ernst
  • Health workers deserve care too: How to protect their mental health

    Corey Feist, JD, MBA & Kim Downey, PT
  • Why the words doctors use matter more than they think

    Erin Paterson
  • 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
    • Why no medical malpractice firm responded to my scientific protocol

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

      Tomi Mitchell, MD | Meds
    • Why funding cuts to academic medical centers impact all of us [PODCAST]

      The Podcast by KevinMD | Podcast
    • Bridging the digital divide: Addressing health inequities through home-based AI solutions

      Dr. Sreeram Mullankandy | Tech
  • Past 6 Months

    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • The silent crisis hurting pain patients and their doctors

      Kayvan Haddadan, MD | Physician
    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • What happened to real care in health care?

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

      Jacob Murphy | Education
    • How to build a culture where physicians feel valued [PODCAST]

      The Podcast by KevinMD | Podcast
  • Recent Posts

    • Why funding cuts to academic medical centers impact all of us [PODCAST]

      The Podcast by KevinMD | Podcast
    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • When rock bottom is a turning point: Why the turmoil at HHS may be a blessing in disguise

      Muhamad Aly Rifai, MD | Physician
    • How grief transformed a psychiatrist’s approach to patient care

      Devina Maya Wadhwa, MD | Physician
    • A speech pathologist’s key to better, safer patient care

      Adena Dacy, CCC-SLP | Conditions
    • Navigating physician non-competes: a strategy for staying put [PODCAST]

      The Podcast by KevinMD | Podcast

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
    • Why no medical malpractice firm responded to my scientific protocol

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

      Tomi Mitchell, MD | Meds
    • Why funding cuts to academic medical centers impact all of us [PODCAST]

      The Podcast by KevinMD | Podcast
    • Bridging the digital divide: Addressing health inequities through home-based AI solutions

      Dr. Sreeram Mullankandy | Tech
  • Past 6 Months

    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • The silent crisis hurting pain patients and their doctors

      Kayvan Haddadan, MD | Physician
    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • What happened to real care in health care?

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

      Jacob Murphy | Education
    • How to build a culture where physicians feel valued [PODCAST]

      The Podcast by KevinMD | Podcast
  • Recent Posts

    • Why funding cuts to academic medical centers impact all of us [PODCAST]

      The Podcast by KevinMD | Podcast
    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • When rock bottom is a turning point: Why the turmoil at HHS may be a blessing in disguise

      Muhamad Aly Rifai, MD | Physician
    • How grief transformed a psychiatrist’s approach to patient care

      Devina Maya Wadhwa, MD | Physician
    • A speech pathologist’s key to better, safer patient care

      Adena Dacy, CCC-SLP | Conditions
    • Navigating physician non-competes: a strategy for staying put [PODCAST]

      The Podcast by KevinMD | Podcast

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...