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Care is in the Details

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To my patient,

Today I learned that you passed away and my heart can't quite process this feeling. Six months ago when we met I only wanted to focus on your disease. It’s funny how at the beginning all I knew about you was what I could read on a computer screen. I knew every single detail of how your body was working and what medical problems hunted your chart. Your mind was elsewhere and your loved ones were hard to pin down. The weeks passed and all of a sudden when your medical conditions were no longer a novelty, when you had taught me so much about medicine that my brain could not keep up, I really started to know YOU. 

I think back to what I knew about you and it feels like little pieces of your life puzzle. You see, you shared with me small details about small days in your life. How you loved scary movies, how you loved my hair because you were a hairdresser once upon a time, how you got your tattoos for no particular reason, and how you had rekindled a relationship with the family that you once thought you’d lost. Of course, I was not alone in taking care of you, and over half a year in the hospital, you gave others some more pieces of the puzzle, sometimes smaller, sometimes a bit bigger — but I can say for sure they were always details they could remember you by. 

I've always thought it's interesting how as doctors we see hundreds of patients a year, but only a few stick in our minds. It's not always the most medically complex or the sickest who remain memorable — rather, it’s those who remind us of our humanity. Those with whom we laugh and with whom we share similarities, those who spark in us feelings of joy. At some point in our careers, we become cold and numb — and suddenly patients like you disrupt and spark our hearts with your passion and life. Patients like you remind us of why we chose this path: the magic within medicine that in a way is the magic behind humanity. You make us feel alive by gifting us a sense of colorful connection. Connection to each other, and to the world around us that we often, while preoccupied with trying to unravel the mysteries of the human body, forget is there. 

With the news of your death, I can't quite put words to what I feel. It's not sadness because I knew you were ready to go, because in a way even though you were essentially a stranger I knew you had lived, really lived. It's also not relief because I will always feel like we could have done more for you, not medically (that part we thought about for hours and hours), but maybe just as human beings. Maybe we should have known you better, maybe just small pieces of your puzzle were not enough, maybe you should not have been such a stranger. Or maybe this is what medicine is. A series of moments where you share just a part of yourself with others and hope somehow that that is enough. 

I hope you knew we thought of you, I thought of you, and my co-interns thought of you long after we had our turn taking care of you. I hope you know that I will always remember what you taught me, that taking care of you was a privilege, and that because of you, I learned more, not only about medicine but also just about life. That yours is a face that will appear in my mind years after my time as a doctor has ended. I hope that during these last few days of your life you were able to sense that.

Thank you,

Your intern

Share stories of your most memorable patients in the comments below!

Dr. Daniela Arango Isaza obtained her medical degree at Universidad CES in Medellin, Colombia where she spent the majority of her life. Currently, she is a second-year resident of Internal Medicine at Beth Israel Deaconess Medical Center. Dr. Arango is interested in medical writing and medical education. 

Image by GoodStudio/Shutterstock

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