ESSAY ON BEING A DOCTOR
Borscheid R. Patient Mentor. Methodist DeBakey Cardiovasc J. 14(3):242-243.
Through the generosity of Charles R. Millikan, D. Min., vice president for Spiritual Care and Values Integration, an annual award competition was established at Houston Methodist Hospital among the resident staff. To enter the writing competition, residents must submit a poem or essay of 1,000 words or less on the topic, “On Being a Doctor.” A committee of seven was selected from Houston Methodist Hospital Education Institute to establish the judging criteria and select the winning entries. The following is the second-place winning entry for 2018; the third-place entry will be published in the next issue of this journal.
Thinking back over the course of my education, I have had the privilege, and sometimes misfortune, of working with both gifted and very idiosyncratic teachers. Take Dr. K, for example: a trauma surgeon and critical care specialist whose daily ICU rounds were both terrifying—if you were on the presenting end of the spectacle—and extremely valuable for the education of the impressionable young minds huddling around the chart rack. He knew everything! (At least and at the very minimum, he knew a lot…if the admiration for his intellectual prowess wasn’t just a manifestation of Stockholm syndrome; after all, it is common to identify with and idealize your tormentors.) Undoubtedly, he did know how to teach: He was never boring, and no matter what subject was discussed, something always stuck in my memory. Becoming a better surgeon each day, one Snapple fact at a time!
Of course, his flamboyant personality did the rest to reel me in. He was a self-professed master of martial arts who would teach us the correct head-butting technique and the resulting thoracic trauma in one breath…not to mention the Samurai long sword (Katana), an indispensable tool to swat the flies at Saturday summer night barbeques (of course). It is interesting how anecdotes and rumors become autonomous and independent of truth. Did Dr. K really switch the ventilator to a weaning mode? When he was in the ICU? After his own open-heart surgery? Because he professionally disagreed with his colleagues treating him? Sometimes the legend is larger than the man, but hey, 90% of my classmates believed the story to be true. Or at least plausible. Or possible. It didn’t really matter if it happened exactly like this or not. The bigger picture was: This guy is BADASS! He inspired me, although I can’t quite put a finger on how, or what to do, exactly. Maybe to go through life with a good measure of self-irony? Or to appreciate the power of good storytelling? Don’t get me wrong—Dr. K has a firm place in my personal Olympus of mentors. He made me think, he made me study, he made me laugh and sometimes cry. He helped me through residency and later on in fellowship. He was my mentor: fearless, sometimes larger than life, and most of all, inspiring.
He is, however, not the mentor I really wanted to write about. The person I was thinking of foremost when I first read the essay topic was a former patient of mine. She probably was not a mentor in the conventional sense, but I still took away a lot from our brief encounter. I believe that she actually taught me the most important lesson of my entire career, maybe even life itself. I am sad to admit that I do not recall her name after all those years, but I vividly remember her face and how she inspired me. She was a woman in her mid-fifties and she had been admitted to our surgical service with a recurrent small bowel obstruction. She had undergone a laparotomy with resection of a mucinous GI carcinoma several years ago and frequently had to be readmitted for conservative treatment of ensuing bowel obstructions. This admission should have been as straightforward as any of the other episodes: NG tube, IV fluids, bowel rest. But it was not. Her obstruction did not resolve, and she finally had to go back to the operating room for exploration. She had widespread peritoneal carcinomatosis, and the only thing we could provide her with was a palliative intestinal bypass for her blocked bowel. She was not any different from the other patients I had seen dying. She rapidly cycled through anger, fear, despair, and hope. She negotiated for her life one moment, only to succumb to dark depression the next.
In the end she made her peace, and her dying wish was to defend her Ph.D. thesis. After her first cancer diagnosis, she had gone back to university to study computer sciences. It had given her a new purpose in life after all the months in the hospital. Her biggest fear now, besides death, was to not complete her studies, to fall short of her own expectations and dreams. It was something she had put her lifeblood into, and now she was faced with dropping out of the race only inches away from the finish line. I am glad to say that she was able to leave the hospital in time. Although I never saw her again, I later heard that she got her degree and died peacefully several weeks later. Her story moved me, and I am still inspired by her perseverance. We all have only a finite span of time, and to fill it with meaning and purpose is the biggest challenge of life. How much time do we waste with routine and irrelevant things?
It’s our dreams that count the most, that make us happy, that fill us with life. They can lift us up in dark times and remind us of how much we matter to the world, even against the odds. When I am lost, I see this woman’s face and it reminds me that life makes sense. Until the last breath. The longer I practice as a physician, the more I feel privileged for the unique insights our work offers to us. A mentor is a trusted guide and counselor, and I believe that our patients truly are the unsung heroes of our education—in medicine as well as in life itself.