Gratitude for Tomorrow

It was my second time shadowing in the emergency department as a medical student. I had just finished my neurology block – a notoriously challenging nine week marathon, and needed a glimpse of the life I’d soon inherit as a healthcare provider.

I was assigned to follow two residents, who happened to be LKSOM alumni, and soon found myself immersed in their patients’ cases and their unknowing ties to my own memories. A 60 year old Black woman with a history of COPD presented with an acute exacerbation. Her socks were identical to a pair resting in the back of my mother’s dresser. A 50 year old Black man with a history of dementia and schizophrenia presented with belly pain after wandering from his care facility. His sister’s exhausted tone over the phone brought my mind to all the unsung women in my family who made innumerable sacrifices to ensure that chronically ill loved ones received the proper care. 

However, there was one particular patient that impacted me far deeper than I could ever imagine. One of the residents invited me to join him in an initial evaluation of a 55 year old White woman who presented with right eyelid drooping and blurry vision. I promptly said yes, prepared to silently recall the pathophysiology I had just been tested on. 

We entered the room, and the resident began taking her history. She hadn’t been feeling well for a while, but ultimately decided not to seek out care until her symptoms began to impact her daily quality of life. In the last five years, the patient lost both her daughter and mother and had been struggling to cope with her grief. She figured that her eye issues were a result of not taking the best care of herself, so she scheduled an appointment with her ophthalmologist, who advised her to seek emergency care. The resident nodded his understanding and began to complete a focused neurological exam and in addition to her eyelid drooping, he found that she had a right lateral eye deviation, decreased cutaneous sensation on the right side of her face and body, and right arm weakness. She hadn’t noticed these symptoms before coming in and soon grew concerned in her facial expression. She turned to me and the resident, and asked in an urgent tone: “Will I be getting out of here today? Is it bad? I have to make my nephew’s wedding tomorrow. He’s all I have left.”

It felt like the air had been withdrawn from the room for a lifetime before the resident softly smiled, and said, “We are going to do our best to figure out what is going on.” The patient nodded and repeated that if necessary, she was happy to leave and come back after being there for her nephew on his special day tomorrow. Emotions I didn’t know were present began to bubble beneath my irises, and I turned away slightly to avoid her gaze. The resident and I left the room together and returned to the work station. There was not a word shared out loud between us – only a look that expressed all the concern we didn’t allow ourselves to show the patient.

Sometimes, it is easy for me to take each day for granted because the road to becoming a doctor is a long, winding one with days, weeks, and months that often roll into each other. However, at this patient’s bedside, I was reminded of how precious every second, let alone day, truly is. I wasn’t able to find out what the future held for that patient, but I quietly carry a small piece of her inside of me so that I always look toward each tomorrow with a heart of gratitude.