Physician-in-Training/Medical Student Category
2014 Richard Spear, MD, Memorial Essay Contest
and physiology to glean some small understanding of the cases
presented. I wrote everything down: tests, diagnosis, complications,
syndromes – all to be looked up later in a private setting so as not
to place my complete ineptitude on public display.
I stood toward the back of the group on a Monday afternoon
while rounding through the outpatient chemo administration unit.
Before visiting the next patient on our list, my attending stopped
and craned his neck to look over the group to find me.
“This patient has relapsed AML and failed BMT three times.
He’s here today for palliative chemo. He’s 10.” My attending gives
me a small nod with a resigned look, as if to say, “There is a dark
side to this job.”
I scribble on my pocket note pad. At least I know what palliative
means.
Then we come upon our patient. A 10-year-old boy, bald and
cushingoid, sitting in a rubber-upholstered recliner with an IV line
appearing from the bottom of his shirt. The other end of the line is
attached to a bag of yellow fluid strung to a pole nearby. Mom and
Dad are sitting in children’s chairs next to his, they