Louisville Medicine Volume 66, Issue 2 | Page 19

SPEAR ESSAY learned could atrophy, and saw first-hand how anatomy goes awry in disease. I learned the cranial nerves in school, and over Christmas break, I watched as his facial nerve no longer summoned the smile I have loved all my life. Each time I went home, he had progressed. I was missing so many “lasts” by being at school. It was not easy sacrificing time with my dad to be in medi- cal school. This time is already considered a difficult period in a physician’s life, and I had the added stress of balancing a full class schedule and a dad with a terminal disease. I tried to channel the very raw emotions I felt to connect and learn from patients and families who were experiencing the manifestations of illnesses and disease. I was overcome with emotion during a panel our class had with a family affected by Huntington’s disease. I explained in front of 160 of my peers, professors and the family who just told us their story, that my dad had ALS. Choking back tears, I could finally mumble, “How do you emo- tionally protect yourself when someone you love so much is degen- erating in front of you?” They all looked at each other, and the oldest sister responded, “Honey, you don’t. You feel what you feel, and you love him through it.” A strict class-goer (I cannot get the social interaction I need via an online recording), I skipped the next day after the Huntington’s panel to drive six hours round trip to spend the day with my dad. We picked March flowers in the middle of February, took silly pictures, and enjoyed an unseasonably warm winter day. That was my dad: bright beauty blooming when it does not make sense. By that point, I had spent seven months studying. Between memorizing anatomy and biochemistry and learning how to provide appropriate care to my future patients, there were many days that I sacrificed picking flowers, and there were many silly pictures I did not have the chance to take with him. Yet, I had a distinct op- portunity and the privilege of foresight to be able to cherish these moments. There will never be a day, a memory or a moment as revered as picking March Flowers in February with my dad. He quickly declined during the summer. The bulbar onset of his ALS worsened his prognosis, and we all suffered as his respiratory muscles weakened. After a full discussion of the options, he chose to have a tracheostomy performed. I remember his anxiety heading to the hospital before this procedure. I remember the way he looked around slowly prior to leaving our house. I remember the way he held my hand in the car. It’s like he knew he was never coming home. Although the procedure went well, he developed pneumonia and had to be placed on a ventilator, on which he lived thereafter. A few weeks into my second year, he voluntarily transferred from our hometown hospital in Paducah to Kindred in Louisville. We both knew he was dying, and he willingly left the comfort of his familiar hospital for a foreign one, in order to live out his last few weeks by my side. My mother was no