In medical school, the lessons and stories have a unifying theme that connects the threads of humanity. In medicine, I could find these stories, the feelings of loss and fear and hope and love. In the face of illness, suffering, and death, we often see the unvarnished sides of the human condition — the more raw sides of our nature hidden behind the decorum of everyday living, behind the curations of professional demands.
Most of medical school — before starting clinical rotations third year — is spent in the classroom, absent from patients. As such, I made it a priority to volunteer at our school’s free clinic, where student-doctors could provide pro bono health care to the uninsured population.
When I met my first patient volunteering, I found these stories again, the stories that I’ve been seeking but have been largely absent in my physiology and anatomy textbooks.
Our patient was a 63-year old immigrant who could not speak a word of English. Everything he said was through a translator. And even so, his sentiments of seeking a better life in this country, his humble attitude towards his job as a factory laborer — these things needed no further interpretation. I smiled. What a privilege it was to meet this man in person, whose story I might have only previously gained access to through a features piece. Being in the same room with this patient face-to-face felt more tangible, more grounded than anything I could read in print, in a newspaper.
Our patient came in with hip pain and acid reflux; conditions that were affecting his ability to walk to work and perform his day job. Medicine has given me the opportunity not only to meet an individual I could not have otherwise met in my personal life but to now play a role in his existence — to improve his health and advance quality of life, to help this man make a living and sustain his professional identity. He needed to return to work to support himself and his family.
The fourth-year medical student asked me to take out my stethoscope and listen to the patient’s chest, a routine portion of the physical examination. Just earlier in the week, I had been practicing the ins and outs of the cardiovascular exam on my classmates. It took a good number of reiterations to know exactly where to place the stethoscope and what we were supposed to be listening to.
I approached our patient and carefully listened to his heart. I closed my eyes. The sound slowly came before me — lub dub; lub dub; lub dub. The beating was rhythmic, soothing and sounded exactly as my classmate’s heart had, exactly as my heart would.
For the longest time, the science that I had been learning in medical school had seemed like an intellectual buffet. The knowledge was tantalizing, and I was rapidly gaining access to vast realms of information that could logically describe the intricate processes keeping us alive. But in the classroom and in the textbook, these ideas were merely notions, abstract concepts that fit together nicely as an engineering equation does, but untested in the realities of every day living. The heart could be explained as a car engine could through series of graphs, but surely our hearts hold greater meaning than a collection of automobile parts.
Hearing this man’s heart, and understanding now through our anatomy and physiology classes what each “lub” meant, what each “dub” meant, and how his heart was autonomously pumping 80 times a minutes to course this liquid we call blood to sustain human life was profound. I had not just peered into the man’s soul, but his very body.
I had come to grasp the significance of something akin to a commonality through the humanities, the idea that there are universal truths and moral principles that extend beyond our differences, not bound to a tongue, a heritage, or a sense of place. But now, I saw how that commonality need not necessarily extend to the metaphysical. As I listened to my patient’s heart, it was biology, rooted in the immutable laws of chemistry and physics that so cleanly entwined us together as a species. For millennia, the human heart had pumped in this beat-like pattern, and for the next millennia, our human heart will continue beating all the same.
Although I never understood a single word our patient said to me, I felt such a strong sense of connection to him. This was the unbridled power of the doctor-patient relationship.
Now as I meet someone new, I’ll think about their heart, how it’s touched and how it can be moved — what elevates it to laughter and to tears, but also its biomechanics — how it contracts and how it pumps.
Without a thorough understanding of how the heart works, I, as a physician, will not be able to help my patients enjoy life’s higher joys. But without eliciting what gives my patients joy, I, as a fellow human, would miss what makes their heart beat at all.
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