Central PA Medicine Summer2020 - 25

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[I knock twice, wait for a response to
enter, then walk into the patient's room. I
see a gentleman seated in a chair, shoulders
slumped forward, head tilted to one side,
eyes cast downward. He looks tired, worn
out, sad. I take a mental note of this and
greet him with a smile.]
Medical student: Good afternoon, my
name is Christina and I am the medical
student who is working with your care
team. Please tell me about what brings
you in today.
Patient: Hi Christina. Nice to meet
you. My head has been hurting a lot lately.

Medical student: How severe is
this pain?
Patient: It's a constant dull ache throughout my chest. I feel hollow, aching, and unseen.
[I consider a spectrum of behavioral states.
Depression? Anxiety? A recent heartbreak?
I decide to slow my own breathing down
and relax my arms. He follows.]
Medical student: Does anyone in
your family have a history of heart disease
or stroke?
Patient: No.

Medical student: I'm sorry to hear
that. Can you describe the pain to me?

Medical student: Do you have any
history of smoking?

Patient: It is a sharp, bounding sensation
that radiates from the base of my head, near
my neck, to the front of my skull.

Patient: No.

Medical student: When did the
pain start?
Patient: About a month ago. It gets
worse throughout the day and makes me
feel exhausted.
Medical student: Do you have any
history of migraines?

[His answers become shorter. I notice we
have not made eye contact yet. Instead of
asking another question, I pause.
He slowly lifts his head. Through tangled
eyebrows, he raises his eyes to meet mine.
Golden amber flecks decorate the warm
brown palate of his irises. I wonder what
those eyes have seen. What do they see
now? Does he see me? Does he know that
I see him?

Patient: No.

I take a seat in the chair next to him.

[He picks his chin up slightly. I see dark
circles beneath his eyes. They look red, like
he has been crying. I slowly soften my facial
expression and adjust my posture.]

[An invitation to listen.]

Medical student: Has anything
helped to relieve the pain?
Patient: Nothing has helped. Sometimes,
I feel pain in my chest too, like a sinking
feeling weighing my heart down.
[Heart attack? Stroke? Trauma? My brain
begins to construct a list of possible diagnoses
to ask about. I look at his past medical
history on the chart. Nothing significant.]

As medical students, we are being trained
to solve problems. We are taught to observe,
integrate, and apply factual information
to help alleviate suffering. Pressed to find
solutions in practice, I wonder why we are
not also taught to sit with the discomfort of
another person's pain. Or rather, I wonder
why we are not taught to sit with the pain
of our own discomfort.

From the beginning of our educational
training, we are charged with the oath to
do no harm. The knowledge, skill, and
expertise of generations of physicians before
us have guided the practices that make our
profession a refined technical art. Yet it is
the moral, ethical, and humanistic drive
within each of us that allows us to treat
others with grace, respect, and compassion.
This is the humanism that we, as medical
professionals, need right now to heal a
hurting population in America. So many
of us struggle to see racism. We may not
have felt it before, so why feel it now?
Because, we made a promise to listen.
We made a promise to understand. We
made a promise to nurture the wounds of
those who cry out in anguish. We made a
promise to bring relief.
It is therefore our duty to diagnose the
pain that eludes expensive scans and medical
exams and practice a cure that preserves
the dignity of a fellow human being. Our
mission to serve is stronger now more than
ever to ensure health equity in the face of
racial injustice.
To the Dauphin County medical community, I kindly ask that you read the
following letter that medical students at
Penn State College of Medicine prepared
for our colleagues and peers. We aim to
share our goal of empathy, patience, and
tolerance with you in the pursuit of becoming exceptional future physicians and
engaging neighbors. Together, We Are...
all striving to make a difference.
Continued on page 26

What happens when we can't see another's
pain? What happens when we don't understand it or know what causes it? Are we to
turn away? Are we to ignore it because it
is complicated and elusive?
Central PA Medicine Summer 2020 25

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