Being Useful

My ringtone, set to full blast, jolted me out of a deep sleep and filled me with visceral fear. The name of my supervising resident illuminated on my phone, beckoning me to the first on-call night shift of my medical career. Ten minutes later, I watched as two surgeons, several nurses, an anesthesiologist and many surgical techs all buzzed around the central focus – a man lying on the operating table. Fit-appearing and in his mid-40’s, he kept his eyes closed tightly and neck arched backwards, lifting his shoulders slightly off the operating table. In a hushed voice, the surgeon said, “Make sure to have a crash cart ready.”

His blood pressure dipped to dangerously low levels. The operation proceeded in an artificial steady state as the blood flowing in from the IV line chased the losses of a ruptured pancreatic aneurysm, desperately trying to keep pace. The man stayed conscious as minutes turned into hours.

I stepped out to find a bathroom around midnight, emerging from the hive of activity into a deserted hallway. The silence of the hospital made the normal chaos of voices and beeping monitors feel like a distant memory. As I walked, I saw a figure sitting alone in the back of a dark waiting room adjacent to the OR. Hearing footsteps behind me, I turned. “Please” she said. “I just got here and I’m looking for information about my husband. He’s getting emergency surgery.” She was around forty, slim, with long brown hair, composed but with a layer of panic hiding under the surface.

I stood frozen, keenly aware of my uselessness. In my dream world, Doctor Charlotte would stand up straight and say something compassionate and informative, appropriately supportive but meaningful, too. Unfortunately, it was only my first week of clerkships. My white coat was crisp, unstained, and simply a front for medical facts written in some textbook lying on the floor next to my desk at home. I knew answers to questions like: what is the difference between the immunofluorescence staining of bullous pemphigoid and bullous impetigo? Which cell surface receptor is lacking in familial hypercholesterolemia? But the important questions: What caused her husband’s aneurysm to burst? And what was his prognosis? Well, those were far above my pay grade (currently in the negatives). For clerkship students who are used to knowing things, the experience of having little practical knowledge, and even less practical purpose, in a critically important moment like this was remarkably frustrating.

I ran and got the resident to answer her questions. When we returned to surgery, there was an uneasiness in my stomach thinking about the woman outside. I waited for a moment of pause while the surgeons were setting up for a new access point. Out of kindness, but also in search of my own utility, I stepped out to find her.

She was still pressed into the same waiting room armchair. “I thought you may want someone to sit with,” I said cautiously, taking the seat across from her. Maybe my hands did not have the dexterity to weave a catheter. I couldn’t direct a code, or suture the aorta, or even place an IV. But sitting here, well, that I could do.

We sat together in the dark waiting room at 2 a.m. in the middle of the pandemic. I listened to her story. She was a playwright raising two young daughters, two years apart. The older daughter was an extroverted force of nature, the younger, quiet and subdued, but powerful all the same.

And she listened too. I told her about my outgoing older sister, also two years my senior, and how our differences had molded us into complements of one another. I told her about the times when we were little kids, the bike rides and mud fights and jumping through sprinklers in our bathing suits. While I spoke, her mouth lifted at the edges and she relaxed a little deeper into the chair. Her gaze fell elsewhere as a future with her daughters, and all its possibilities, unfolded in front of her on the distant floor of a hospital waiting room.

After five hours and four units of blood, the surgeons found the bleeding artery and coiled it, saving the patient’s life. He made a full recovery and returned home to his family. A few days later, an email from his wife popped up in my inbox. “Tell your mom and sister that your stories of them made the worst night of my life bearable.”

Coming to the end of my third year, I wish I could say that the feelings of uselessness have abated and possibly transformed into the confidence I so strongly desire. I wish I could say that I’ve become the Doctor Charlotte of my imagination, with her composure and knack for knowing answers. But truthfully, I’m just a slightly more experienced version of my previous self. I’m learning, as frustrating a process as it may be.

I frequently remind myself of my 2 a.m. conversation in the waiting room when I lacked any clinical knowledge to guide me. Maybe that was the beauty of it, learning that humanity alone is often “useful” enough. And I hope that on the day when the right words roll off my tongue and clinical knowledge feels like the air I breathe, I will still say, “I thought you may want someone to sit with.”

Charlotte Walmsley is a 4th year medical student (’22) interested in Internal Medicine and Oncology. She is passionate about medical humanism, writing, and using the power of reflection to improve patient care. This piece was selected as a winner of the Gold Humanism Honors Society Celebration of Creativity essay contest.

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