Gratitude

Pam Lenkov

Sometimes students can forget, in the excitement of learning, that each correct diagnosis has consequences for the person who receives it. “To a First-Year Medical Student,” written from the perspective of a teacher, is about tempering learners’ elation at acquiring new skills by reminding them that each human being is more than the sum of their physical parts. Themes include humanity, enthusiasm, respect, and appreciation.

To a first-year medical student

Ambulatory patient number 1
Was in today to be the lungs
Where last week
Her heart was paramount
To the learning process
Beatific smile worn in assent
(Should sainthood be conferred?)
Allowing medical students to navigate
The presence of her breasts
To map the landmarks of her chest
And I teach you to preserve their dignity
And so the weeks elapse
This patient 1 gives way to 2, then 5, then 10
The last who on that day afforded you a knee arthritic,
A varicosed leg, and a liver edge
Skills gained, skills reinforced
Examinable first then practical, practicable
But they departed, fated with their findings
Those rales you auscultated
Succumbed to failure (of the heart)
The turbulence you palpated
(The “thrill” that thrilled you!)
Belied the fatal valve
The jaundiced eyes, you observed
The wasted frame
Was overrun (“gastric cancer” he told you, I know)
Many now deceased after years of being “the patient”
These lungs were his
This heart was hers
This kyphotic back
Like so much scaffolding
Around the history
That you have taken/built, was wrapped
I want to say
“Be rapt today!” because
When all that knowledge gained is at your “clerking”
fingertips
You will (you must!) remember them