I always feel like I should be running when I am pre-rounding. A light jog at least, to keep pace with the thoughts racing inside my head. I’m lost in simultaneously trying to map the quickest route to my patient on Founders 12, finalizing the plans for my patients, and trying to remember if this new service has morning conference. I realize if I don’t hurry, I won’t have time to run the list to the fellow before rounds. So I focus on the hollow thud of my hand-me-down black cap-toe shoes and begin apologetically weaving my way to the elevator bank.
As I step onto the elevator next to a patient, I recognize the small talk she makes with her overworked attendant. I have heard it before. “My daughter once had an MRI of her knee, but I don’t know anyone who has ever gotten an MRI of their head. It will probably show nothing, they never show anything.”
In an instant, I am back in the MRI, the interrogating thuds of the machine closing in on me. Waiting for the test to be over, waiting to be better.
Ding! It’s my floor, and I focus on the quickening thuds of my shoes as I speed away from the elevator. The constant clacking provides momentary distraction. I start to mentally prepare myself to try to sort out my patient on Founders 12, cursing myself for not seeing this patient earlier. I still don’t really understand what is causing their dizziness “that just won’t go away.” We’ve ruled out the serious and the common, and I’m unsure where that leaves us. Why did I leave this patient for last?
Finally off the elevator and onto Founders, my eye catches a room. It’s a room I’ve been in before. It’s bedside rounds, an anxiety inducing clerkship year tradition. The attending is beginning her teaching point on biliary pathology as she finishes palpating the abdomen. The medical student, uncomfortable in his unfamiliar attire, stares back worryingly at his attending, hoping there won’t be a question about some long-ago forgotten point of pathophysiology.
Suddenly, I am back alone in the exam room stuck between two worlds. My brain is still mired in the thick fog of a concussion, unsure if I am allowed to use the word “anterolateral” as a patient. Reflexively, I dread the questions about spinal cord localization interspersed during my neuro exam, but I welcome the momentary distraction they provide from being a patient.
My head snaps back forward and I side-step a linen cart rumbling by. I focus harder on the clack of my well-worn leather soles. The time between each thud of my soles grows longer as I approach my destination. I fall back into routine to calm my nerves. I scan my list. Review the name. Check the room number. Take a deep breath in and cross the threshold.
As I gather the unchanged history and unchanged exam and answer questions about the plan for the day, I prepare to head for the safety of the door. Then the patient asks me the question I’ve been dreading the whole morning.
“When will I get better?”
I sit there wanting to say so much. I want to tell him how I have asked myself that question so many times. I want to tell him how desperately I have searched for an answer to that question. I want to tell him he is not alone, that I am not alone.
I sit on his bed silently. I have sat on this bed before. Shielded by the lessons I have learned day by day, I muster forward the only answer I know to give. “I don’t know.” And I sit there a little longer.
Nick Rizer is an MS4 at the Perelman School of Medicine.
