I was recently in Washington, D.C. for a conference when I reached out to a friend from medical school. She was in the trenches of intern year but generously sat down for dinner with me.
“So,” I began, “How are you? How’s the intern year?”
She proceeded to tell me her wide array of experiences, a rollercoaster of emotions.
One of the most challenging parts, she said, was breaking news of a patient’s death to their family. Doctoring 101 in med school doesn’t necessarily prepare us for the reality of telling someone their loved one has died. It wasn’t a rarity, either, especially during her surgical oncology rotation. Those patients came to them as a last resort. “We’d open their bellies ridden with cancer, fill it with chemotherapy…you can only imagine the physical toll on the patient’s body.” The emotional part, even worse. Patients may know if they are dying, and if they don’t, her medical team eventually will have to break the news to them. There is only so much that medicine can do, only so much that doctors can offer. If we’re unable to cure all and can’t treat diseases, what can we do?
I sat in a moment of contemplative silence, ruminating in my head what it would be like to break this kind of news to someone and to be responsible for their last few strings of hope. Clocking in early and clocking out late, to carry burdens no one else can see. How life and death can be all part of a day’s work.
For my friend, she said she recites a poem to herself to remind her of the duty and the privilege to be fully present for the dying, the patients, and all people made in the image of God. The poem is called Prologue, written by Yun Dong-ju, a Korean man of faith who wrote resistance poetry in response to the Japanese colonialism era.
Until the day I die
I long to have no speck of shame
when I gaze up toward heaven,
And yet like the windblown leaf,
I have suffered
With a heart that sings the stars [God],
I will love all dying things.
And I will walk the way
that has been given to me.
Tonight, again, the wind brushes the stars.
There is a particular verse that she repeats in her head, as if a mantra reminding her why she is in medicine, why she is doing this in the first place. “With a heart that sings the stars, I will love all dying things.”
In many ways, we as students and young medical professionals are relatively healthy individuals; the majority of us are in our 20s and 30s, the peak of health. We are not consciously aware of it daily, but we as humans are all dying. As dark as it sounds, our bodies will not last forever. From dust we shall return, but while we are here on earth, we can make the most of our lives in service to others. To love all dying things is to love your neighbor, selflessly care for all patients regardless of their situation, attitude, preferences, and prognosis. It is not easy. It is challenging and difficult, as my friend can attest, especially when we are weary and fatigued from long hours and emotional exhaustion. But with sacrificial love, we can care for the sick, especially the terminally ill; they may feel like they have lost all hope or are looking for a source of peace and comfort. The dying may feel alone, or weary; maybe they are ready to say goodbye, maybe they are not or are unable to.
As trainees, we ask ourselves as part of becoming a physician: how can we be there for our patients? We can walk with them. It’s OK to invest emotional energy; it’s OK to try to block out those emotions; it’s OK to cry, it’s OK to try to stop yourself from crying. How do we be self-preserving yet care for our patients with all of our abilities?
I am flying back to school; the airplane speeds on the runway and lifts off. An hour later, I look out the window and see barren trees, the ground punctuated with pockets of icy snow. The wind blows and the plane descends, slowing down on the runway. Clouds hover above, hiding the sun, turning the sky to gray, and in my mind I am repeating this verse, reminding myself to love all, no matter the prognosis.
Anna Delamerced is a medical student at the Warren Alpert Medical School of Brown University. Born and raised in Cincinnati, Ohio, she enjoys exploring the crossroads of writing and medicine, and listening to patients tell their stories. Anna is a Doximity 2019-2020 Fellow.