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A Wedding and a Funeral: A Medical Student’s Perspective on Death and Dying

2020; Lippincott Williams & Wilkins; Volume: 95; Issue: 7 Linguagem: Inglês

10.1097/acm.0000000000003208

1938-808X

Tanwe Shende,

Diversity and Career in Medicine

To the Editor: Before entering medical school, I believed the role of a doctor was to heal with medicine. In my first few years of medical school, I was taught the pathophysiology of diseases and mechanisms of therapies that would treat them. However, during my clinical rotations, I had to confront what happens when our tools as physicians can no longer help. My first experience telling a patient that there was nothing left to do medically was during an intensive care unit (ICU) rotation. I sat with my patient, struggling to talk over the roaring sound of her Vapotherm. We discussed what she understood about her cancer, and I explained that she had been moved to the ICU because her oxygen requirements were increasing. I opened her most recent imaging that showed diffuse opacification of her lungs and told her that she was having an adverse reaction to her current treatment. I watched the tears stream down her face knowing she understood this meant that her last line of treatment had failed. In that moment, I realized I still had the ability to help her, but in a different way: I would help her die. I asked her what she wanted to do with the time she had left. Her answer was simple: remarry her ex-husband. So, we gathered bridesmaids, groomsmen, and a priest, and we had a wedding on the unit—a first for everyone. In our medical training, we rarely spend time discussing the process of death and dying. We often forget that when we lose the ability to fix the medical condition in front of us, we still have the ability to treat the person. We have the capacity to listen to our patients, and the therapeutic benefit of that is often immeasurable. Furthermore, these experiences provide a seamless bridge for physicians and residents to teach students how to deal with death by introducing the topic of palliative care and providing a space to debrief after the loss of a patient.1 My patient passed away shortly after her wedding, but the lesson she taught me will stick with me through many more firsts. Acknowledgments: The author would like to thank the University of Arizona College of Medicine leadership for their mentorship and support. Tanwe Shende, MSFourth-year medical student, University of Arizona College of Medicine–Tucson, Tucson, Arizona; [email protected]; Twitter: @tcshende.