This was the advice I received from a remarkably kind attending while completing a one-day elective as a pre-clerk in pediatric neurology. I held these words close with the anticipation of writing them down in my journal that evening. It was a terrific day of learning and exposure to the specialty, but I did not expect how prophetic the attending’s words would be after just eight hours on the service…
Our last case was an infant boy admitted to the pediatric intensive care unit after a cardiac arrest and anoxic brain injury. He was experiencing clinical and subclinical seizures and was intubated. It was suspected that he had sustained a non-accidental acquired brain injury from his young mother who had a history of mental illness, violent behaviour, and suicide attempts. With brain hemorrhages of variable ages, the speculation in the PICU was that the mother had been physically abusing her son his entire life. His entire body was swollen. The grandparents clung to their grandson through holes in the incubator and were reciting prayers.
Pediatric neurology worked with the PICU team and social workers to determine how to proceed with the case. Prognosis for the child was poor. As I sat in that meeting room I experienced my own physical response to the emotionally troubling situation: the inside of my body burned like an inferno; my throat collapsed like a deflated balloon; my heart beat in my chest like a tight drum. I thought back to the wise words the attending had offered earlier.
What struck me most about this clinical encounter was how similar yet different I was from that young mother. She was just a couple of months younger than me. She had grown up in the same city. Had we gone to the coffee shop we could have been mistaken for friends. How different our lives were; how similar they were at the same moment and place: two young women, in the same room at the hospital’s PICU, discussing the same child’s fate. We had different levels of education, different responsibilities, different socio-economic statuses, and most likely different futures. I could not ignore our similarities nor our differences as we smiled at one another upon meeting; they stared at me right in the face.
This patient and their family reminded me of the vastly different trajectories my life could have taken. It sounds simple but in reality it becomes quite complicated: the circumstances and decisions we encounter can lead us along colourful and varied journeys from our average cohort, whether we start off similarly based on any factor such as our sex, our year of birth, our hometown, or even our family. Perhaps part of medicine includes understanding that the patient narrative which explains the story of their health and social status is very rarely straightforward. With this realized sensation of gratitude for the privilege that has been extended to me, I am reminded of and inspired by my responsibility and duty to help others. Thankfully a career in medicine will provide me with many opportunities to meet different people along their own journeys in health and in life. I look forward to my future career serving the Canadian public, no matter how similar or different from me they might be.