Introduction to Medicine

Nothing could have prepared me for my first true introduction to medicine. I was privileged to care for Bob as his nurse on the palliative unit. He was a terminally ill patient undergoing both radiation and palliative care. Bob was no longer coherent to make his own decision, yet he had to choose between continuing aggressive therapy or receive comfort care. His children wanted him to give life a “fighting” chance and were not ready to learn about hospice care. Bob’s prognosis was poor and treatments only made his ailing body weaker. His children were unable to visit due to financial circumstances. Their only portal to him was through broken telephone conversations.

I will never forget the day Bob died and the months that led up to it. The nursing staff and I were disheartened to see the pain that Bob had to endure. He was often short of breath and had severe pain unrelieved with high doses of morphine. His progress with treatment plateaued and gradually declined, but his children were hopeful and adamant about treatment. The day Bob left us, I transferred him to the intensive care unit for heroic life sustaining measures. He was bleeding out from his tumor, and no amount of pressure stopped the bleed. I wanted to get his mind off the pain, so I took his hand and started talking. We spoke of everything from his days as a commercial pilot to his feelings on starting the first grade. He told me his favorite place to fly was to the Philippines. He met his second wife on the plane. Bob died in the ICU without any family, connected to tubes and IVs, and commotion of nurses rushing in and out to take vital signs.

I left work frustrated and disappointed. What had upset me about my day with Bob? Surely, I have seen people die and studied the human anatomy. That day, I had experienced one of the most disheartening and demoralizing aspects of medicine. For all its power, it cannot always prevail.

The frustration in me diminished when I finally learned the embedded lesson. It breaks my heart that Bob died with alarming machines, tubes and lines that wired across his body. There is no way for me to ever find out how he would’ve wanted his last days, but I learned to honor the patient and family’s wishes with the utmost respect. Bob trusted his end of life decisions to his children. Therefore, their decisions were his. In the end, I was privileged to have gotten to know a pilot who made dreams come true, reuniting people from different places in the world.

Before then nothing in my personal, academic, or volunteer experiences had shaken my single-minded commitment to healthcare. This pivotal incident confirmed my decision to pursue medicine. Of course healing, curing and saving is much more rewarding than trying and failing, but the irreplaceable human element makes the fight against sickness worthwhile. As a nurse, I have had many satisfying moments but my experience with Bob inspired me to challenge my comfort zone and take a proactive role in healthcare. The struggle against sickness is a lonely battle, and patients have the innate right to quality end of life care that honors their wishes.

While I may not have taken the direct route to medical school, I took the path that suited me well. The seeds of my ambition arose from the nursing experience that gives me the passion to drive through the difficult courses and affirms my decision to medical school. I want to service my patients not only as a healer, but as a friend, supporting them in their toughest moment.