the conflict of hurting to heal

Elli was in town this weekend (he hates it when I call him that, but some habits die hard). I've been meaning to share his post for quite some time, but haven't found the right words to introduce it. I remember it often when I'm in the hospital. Sometimes I get the thrill of seeing my designs and devices on patients, but I'm often immediately brought back down by the realization that to see my success is to see their suffering. Elli's words are humanizing - a reminder of the "conflict of hurting to heal."

Having a thug contest at Cypress Street. The Lou is no match for A-town.

Current location:	Third Floor Carrels
Current mood:	thankful
Current music:	Pandora

Sport

In the past two days, I've had a lecture/case study and read about ALL. This reminded me of my first patient, our anatomy cadaver. Although we couldn't help him in any way, I certainly hope that all he taught us will help countless patients during my career. I wrote this about him for the Cadaver Memorial Service at the end of our first year.

For Sport

We have been told that our patients will be our greatest teachers, and we will always remember him as our first patient and surely one of our greatest teachers.

The bulletin board called him, “African American male, age 20, acute lymphoblastic leukemia.” We found that we wanted to know him better than that. We started by looking at his face. Some of us needed to see his face the first week, so we pulled back the cloth and stood in silence, taking in his features. Others just saw the contours through a freshly wetted cloth at the end of the day. Either way, he became more than a body to us, he was a person, and as we pulled him apart piece by piece we felt the conflict of hurting to heal, of having to harm and invade our patients to try to make them better. With him the conflict was even more poignant as we harmed a man we could never heal. On the day we began to dissect his face, one of our group members cried. The rest, though stoic, understood why she was crying. We called him Sport. It took some time for this nickname to catch on. We first spoke of him in hushed tones, with no name at all. We came to know him too well for him to not have a name, so we gave him one. Eventually, we found that the nickname Sport fit him much better than anything else we could have thought to call him, short of his real name. I hope he would not consider it irreverent that we called him by this nickname. It was not given out of callousness or even convenience, but it was more like the way you sometimes find that you and your friends no longer call each other by name, but rather by nicknames that just fit after spending long quality hours together. Sport became a friend after long hours together, and he deserved a friend’s name.

Had he been a real patient in the hospital, there were many times we would have called him a “Difficult Patient,” or even “Noncompliant.” Our note in his chart might have read, “Patient is uncooperative with the week’s prescribed regimen of completing pages 53-67 in Grant’s Dissector.” We struggled with his 20-year old connective tissue and with the fat and lymph tissue that coated and invaded his body during the course of his disease. We left last almost every day and stayed late on other days, and we still never seemed to finish a dissection. Even TAs and professors seemed to occasionally leave our table in frustration in search of an easier dissection with clearer structures. And yet, we toiled on. Our struggle was rewarded when we discovered beautiful structures not yet broken down by long years of life. We became more confident in our dissection technique. We felt that we would be prepared if we ever operated on a young body. Through our “noncompliant” patient, we learned to work hard for our patients, and we learned that the extra time and effort will pay off in the end.

We all wondered what led a 20 year old man to give his body to be clumsily dissected by untrained, awkward hands. We talked about it often as we went about the business of anatomy lab. For other tables, the conversation may have been similar as they pondered whether or not they would give their body after death. Still, I imagine the thrust of the conversation was significantly different…as other tables wondered whether they would be willing to give their bodies after a long life like so many of the cadavers, we wondered whether we would be willing to give our bodies now. As one of our group exclaimed on the first day, “he could have been on Facebook.” That really hit home for me. I hope we would have been facebook friends, but instead of checking his status updates, we were exploring his innermost parts. We did not know him during his all-too-brief life or during the illness that unfairly shortened his days. I wish we could have known why he gave his body…what his hopes were for the future doctors who were with his body during its last few months as a body. We speculated that maybe he wanted to give something back to the medical field that we hoped had treated him skillfully and compassionately. Maybe he was just young and rebellious and wanted something extraordinary done with his remains. Maybe after such a short life, this was a chance for him to have a legacy carried on in time by the four of us who so benefited from his gift. We will probably never know who he was, what he was like, or why he gave his body. Our great hope, Sport, is that we will become the kinds of doctors that will make whatever reason you had completely worth it.

Thanks friend, and godspeed.