name. She seemed reluctant to talk. After a bit of cajoling, she
finally emerged and said in a flat tone, “I don’t want to be stuck
again for lab draws.” This was before I could even tell her what was
going on. I understood that being a teenager with Type 1 diabetes
mellitus, she would most likely have had multiple hospital admis-
sions, numerous encounters with health care professionals and was
maybe, just tired of the whole system. I did try to explain to her
the gravity of the situation. She was in severe acidosis, and prompt
therapy was required that entailed fourth hourly venepuncture, to
tailor therapy with appropriate fluids and insulin. To add to that,
she decided to change her status to DNR (Do
Not Resuscitate), if the need arose. I was in a
predicament. Her mother left her at the emer-
gency room, and had gone home to tend to her
siblings. The passive aggression that she was
trying to portray might have been a plea for other patients. I was curious and proceeded to learn more about
her. I found out that she was spending her time regularly with these
patients, reading them stories and poems, giving them hope and
joy, although her time was limited. It was a moment of clarity. I
was struck by her selflessness, and was deeply motivated to imbibe
this invaluable trait.
help, or a ploy to gather more attention. What
did not help was that maybe, she was not ma-
ture enough to understand the repercussions
of her decision. I called her mother to inform
about the situation, who then came back to
the hospital to talk to her. Seeing her mother,
the patient finally agreed to the therapy. The
seemingly simple, protocol-based admission
had become unexpectedly complicated. that they make it through their acute illness.
My rotation in the intensive care unit gave me
many such encounters. At times, I would be
the only resident managing them and it would
be a struggle to keep up. Knowing that each
patient had someone who loved them and was
intently praying for them, gave me the strength
to keep going and not give up on these patients
even during trying times. Seeing patients who
survived these ordeals and their gratitude furthered my resolve.
It gave me courage and reinstated faith in my abilities as a healer.
My mother, a neonatologist, was my inspiration to be a doctor.
I used to watch her battle incessantly for the lives of sick newborn
babies. The happiness when they made it and the sorrow when
they did not was a part and parcel of her life.
But I could never really comprehend that, till
I had to fight my own battles. We routinely
admit critically ill patients with multi-organ
dysfunction and a high mortality risk to the
intensive care unit. Each of these patients re-
quires undivided attention and care to ensure
"Some patients
are so well read on
their illness that a
wealth of knowl-
edge can be gained
just by interacting
with them."
Another incident involved an elderly male, unfortunately not in
the best of health, who demanded that everything be done, in spite
of a poor prognosis. Dialysis dependent, with a failing heart, liver,
multiple strokes and peripheral vascular disease, he was recently
diagnosed with a urinary bladder mass on imaging. He demanded
that the mass be evaluated and was interested in pursuing further
therapy, although the surgeon advised against it, given his co-mor-
bidities. He was in a state of denial and was scared. (Who wouldn’t
be?) I sat down and spent some time talking to him. I listened to all
of what he had to say. He was worried about his wife, who was also
in poor health and he was taking care of her. His children were not
very supportive. With his permission, I called his son and explained
what was going on. His son was apologetic and agreed to help out.
The patient was appreciative and having family support helped him
accept his condition.
In both of these instances, I learned that to help them, I had to be
patient and put in the extra effort to understand what the underlying
issue was, allay their fears, and be more supportive.
I still remember the day - during an oncology rotation - I met
a young lady suffering from terminal cancer. The usually gloomy
chemotherapy ward was alive with noise and laughter. She was
enacting a play and had captured the undivided attention of the
I have always thought that being a good doctor meant having
good clinical skills and staying up-to-date on clinical advancements.
But I have come to realize that is not enough. My patients taught
me so much more. I learned that it is important to be compassion-
ate, empathetic and most importantly, a good listener, for a good
therapeutic relationship. I was my patients’ advocate. It is also
essential to give them hope and to be there for them when things
do not go as expected.
I have started believing in miracles, for I have seen people who
have survived against all medical odds. Throughout this series of
epiphanies, I have sensed a change within my soul and my faith in
people has been constantly renewed. And somewhere, deep with-
in me, I have started yearning to be a better person and to serve
whole-heartedly. They taught me that being a doctor is an essential
service to mankind; something I will be eternally grateful to be
involved in, and so I continue on this voyage, strengthened by their
trust, ready to face unknown perils.
Dr. John is an Interventional Cardiology Fellow at the University of
Louisville.
APRIL 2019
13