Student Colleen Drapcho Published in Academic Medicine
Colleen Drapcho, a fourth-year medical student, was recently published in the Association
of American Medical Colleges' journal, Academic Medicine. Her reflective writing piece,
“To Know by Heart” follows:
To the editor: It was the end of my first week on the general surgery service, my
first rotation of medical school, when my team admitted 3 new patients. Despite my
immediate instinct to avoid taking the “very complicated” patient with a small bowel
obstruction, I volunteered to take her. Having only presented 3 patients to staff
as a fresh third-year medical student, I had no clue how to tackle this new case.
At about 40 years old, she had been diagnosed with Stage IV cancer. She had undergone
therapy but developed recurrence twice before she was deemed nonoperable. I fumbled
through my presentations the first couple of days, but after reviewing her complex
history multiple times, I began to know her story by heart. She quickly grew accustomed
to my usual barrage of questions during our morning routine. With each visit, not
only was her history becoming permanently affixed to my memory, but the patient herself
became ingrained in my heart. I never thought I would look forward to the progression
of someone's bowel habits as much as I did hers, with desperate hopes for a natural
relief of her obstruction. Despite aggressive management, the obstruction failed to
resolve. The discussion of hospice care became the only therapy left that we could
offer her. After the emotional turmoil of our definitive care discussion, I returned
to my patient's room the next morning. She smiled when I entered, and I immediately
felt the tears well up in my eyes and trickle down my cheeks. “Sweetheart, come here.”
I sat on the edge of her hospital bed as she said, “Don't you be sad for me for one
second. I make the choice every day not to let any situation or diagnosis dictate
my perspective of life. I have been blessed with many long years of love and happiness
that I wouldn't trade for any other life, even if it meant I wouldn't be in this situation.
Today I know, I get to go home.”
In the weeks following her discharge, it felt odd seeing unfamiliar faces in the hospital
bed where I examined her so many times. My first complicated patient, who I was initially
so scared to pick up, taught me a lesson about life and patient care that cannot be
learned from any PowerPoint, lecture, or test. From that encounter forward, I have
endeavored to make the choice every day to know each patient by heart.
Drapcho, Colleen M. To Know by Heart, Academic Medicine: February 25, 2020 - Volume
Publish Ahead of Print - Issue - doi: 10.1097/ACM.0000000000003239