“Do you have a key?” my grandma asks me. I hesitate and she repeats herself, “Do you have a key to this place?” She is sitting in a hospital chair behind one of those hospital tables with a tray full of hospital food in front of her. She is practically skin and bones; her shirt and pajama pants are hanging off of her. My mom is sitting on the bed, staring at me.
“Yes, of course,” I respond. My grandma nods approvingly and relaxes slightly, as does my mother. It is interesting how quickly lying becomes the right thing to do. I inspect her face; her chin has tiny dark hairs protruding that I never noticed before. Her normally perfectly tidy hair is poofy and slightly tangled.
My dad always joked about how dementia runs in our family, “You will be changing my diapers one day!” I have never thought this was funny. I hate thinking about my parents aging; I actively avoid these anxiety-inducing thoughts. But to my grandma, it was no joke and it was not something she avoided. She had a will, a do not resuscitate order, and no supplemental nutrition allowed in her end-of-life plan. Despite all of her clear wishes for her end of life, my family could not help but try to extend it.
While we do not agree on most things, my family was united in getting my grandmother to eat. Four days earlier, my three siblings and I crowded in the kitchen for an impromptu brainstorming session. My mom, a personal trainer who kept a strict ingredients-only household, shouted out more ideas than anyone. “Is cake too much?” someone asked. “It might be too sweet,” someone else said. We collectively decided on a milkshake: the perfect combination of easy to consume and delicious.
Two days ago, my sister made a milkshake with rocky road ice cream to bring to my grandmother. Two days ago, my grandma loved the milkshake. She enthusiastically nodded her head and drank the entire thing. Today, she is disgusted by it. She takes one sip and immediately shakes her head, scrunching her nose with pursed lips. She pushes the milkshake away from her. I cannot blame her for her lack of appetite. The smell of a hospital is not particularly appetizing. I look over to my sister. She is unnaturally still, fighting to maintain a neutral expression but her eyes begin to glisten. I discreetly reach over to grab her hand. My mom reassures my grandma that it is OK, and pushes the hospital juice in front of her.
Despite my grandmother not acting like herself, she is the only truthful individual in this hospital room. I am pretending to have a key to the hospital, my sister is pretending not to cry, and my mom is pretending that everyone is OK.
This was almost four years ago, and I am now starting my fourth year of medical school. My training has been many things; however, one thing I did not expect was how much “pretending” has come in handy. Pretending to be OK, pretending to retain everything, pretending to be an older woman with chest pain and then pretending to be the doctor treating her. Part of medicine is pretending and playing until all of a sudden it is not. You hear the musical quality of a wheeze for the first time and think someone’s phone is going off.
Maybe pretending is just another word for practice, and I am grateful for this opportunity to practice medicine.
Paige S. Whitman is a medical student.
