2024 2nd Place GHHS Essay Contest Winner
"The First Time"
Justin Abe, MS2
After rushing around the wards from patient to patient, my preceptor and the accompanying resident slowed to a stop in front of a white conference room door.
“This is going to be tough, so it’s ok if you don’t want to sit in for this one,” the resident warned, making direct, albeit brief, eye contact. “We have to tell this family that their son is brain dead and they’ve been waiting to see whether he would recover for a while.”
I took a deep breath. “Thanks for the heads up– I would still like to join you, if that’s ok,” I replied.
The resident nodded and opened the door as we introduced ourselves and sat beside the patient’s family. The pleasantries were brief-- everyone knew why we had gathered.
“I know the last few days have been a whirlwind for you... what is your understanding of the current situation?” my preceptor began.
As the family responded, my preceptor nodded and softly shared the results of our examination and tests, as well as the ultimate diagnosis.
“So... what you’re saying is... he’s brain dead,” the mother said numbly. “He’s not going to get better.”
My preceptor nodded. “I know this is not the news you wanted to hear and we’re so sorry this has happened to you. I want you to know that we’ll be here for you in any way that we can.”
We all sat in silence. The clock ticking on the wall was deafening, each stroke seeming more forceful than the last.
“Can my family and I go outside to talk for a little bit?” the mother whispered.
“Absolutely, whatever you need,” my preceptor said. “Actually, would you like to stay in the conference room? We can leave and give you some privacy.”
The mother nodded, her hands rising from her lap quickly to cover her face. As we stood up to leave, it seemed like the family finally had permission to grieve. The mother burst into sobs, clinging to her partner. I realized that this single moment had ended the ambiguity that I’m certain had caused multiple sleepless nights.
Suddenly, everything felt real– this wasn’t any practice problem or mock case. This was a real family, with a story I would never be able to completely understand, who had just experienced a pain that no one should have to experience.
As my preceptor carefully closed the door, the sounds of mourning were abruptly cut off into silence.
Walking down the hospital corridor, my mind was still in the conference room. My chest felt hollow thinking of how we would go on with the rest of our day and how that family would remember those agonizing minutes for the rest of their lives.
“Are you ok?” my preceptor asked, as he walked ahead of me.
I nodded and gritted my teeth, but I could feel the pit in the back of my throat rising. I couldn’t stop the hot tears that spilled out and blurred my vision. “That was really hard to watch,” I managed with a shaky voice, turning away from my preceptor as I tried to avert his gaze.
My preceptor, hearing my voice waver, slowed down to walk beside me and gave me a few encouraging pats on the back.
I took a few deep breaths. “Sorry for losing my composure,” I said quietly, wiping my face. “I’ll try not to let it happen again.”
“Don’t be,” my preceptor said gently. “I’d be more concerned if you didn’t.”
We continued to walk in silence for a few minutes.
“That is never an easy message to give,” my preceptor said softly, slowing to a stop.
He turned towards me and gently gripped my shoulder. “But the thing I want you to remember is this,” he said firmly. “You cannot allow this to become like a routine.
I know this is your first time experiencing this. This is not the first time I’ve given this kind of news and unfortunately, it probably won’t be the last. But even if you have to break that news a hundred times in your career, remember it’s always the first time for that patient or family.”
Amid the whirs of the beeps, buzzes, and muffled hospital chatter, I could feel my view of our encounter changing already.
“It’s important to prepare yourself so we can continue to serve other patients after we deliver the news, but we also need to be near enough to support all our patients and their families. We have a duty to our patients to be with them.”
As I progress through my medical career, I hope many things about me will change. I hope to sharpen my clinical skills, hone my ability to construct a differential diagnosis, and become better at selecting an optimal treatment plan. And yet, at the end of this long training journey, I hope my heart for patients will still be as soft and empathetic as when I first started.
On that day in the summer of 2023, my preceptor taught me far more than the medical criteria for making a diagnosis of brain death. While I try to fill my medical knowledge toolbox more and more, I also want to remain curious about every individual patient’s story and be understanding of the range of emotions that medical ailments can bring. As Sir William Osler wisely noted, “The good physician treats the disease; the great physician treats the patient who has the disease.” Even after decades of practicing medicine and after hundreds of patient encounters, I hope that I can treat every patient with the patience, grace, and respect that every human being deserves.
