viral lessons

It’s the night before my first exam in medical school.

Excusable emotions would be somewhere around anxious, nervous, terrified, or bubbly confidence. But more than anything I feel an intense sadness.

Today was the first time I got to step into the shoes of what owning a white coat means. An acquaintance, someone I’ve hung out with only about half a dozen times, asked me to help him change his wound bandaging, since he needed someone he knew who wouldn’t be “freaked out by blood”. Since I am now officially a medical student, he assumed I would be the right person to ask; if not for that we aren’t close enough for him to choose me as the person for such a favor. I knew little of his condition but that I was in for a surprise. The preceding weeks I got a picture of him in a hyperbaric chamber and the word encephalopathy in a text. With a medical education of eight days, most of which has been spent dissecting a dead woman face, I did what any good student does and turned to google: a disease in which the functioning of the brain is affected by some agent or condition (such as viral infection or toxins in the blood). Vague enough to be confusing, specific enough to be alarming.

When I came in, he was sitting at the kitchen table with clean towels spread over it. There were the orange stains of iodine, a pile of used alcohol wipes, and medical instruments sealed in their sterile wrapping. A paper facemark covered his mouth but his eyes gave away a smile as I walked in.

“So,” I said, “will you please tell me what the hell is going on with you?”

He took a breath. “We’ll get there. I just need to talk about normal things for a while.”

I stood corrected, smiled at him, and replied, “totally fair. What should I do first?”

I got my hands washed and sterilized. We moved around each other slowly, We showered him with alcohol wipes to clean around the IV in his bicep. Using small motions, we cleared the crusted pus that has been unattended to all week. Communication was short, either instructional or a sarcastic joke to maintain a light giggle in air air. As we worked he told me the IV was for an intravenous antibacterial he was taking. And for the many other meds he was pushing through it. Anticoagulant, another protein-biding something or rather, words I recognized but had no idea what they meant.

After we finished an hour later, we sat on the couch and he taught me how to slowly push in his meds. 10 secs for each mL. If you go too fast he gets a stinging in his mouth and eyes. He slumped down to the floor afterwards resting his head on my knees. I started massaging his tight shoulders.

Slowly, his story unfolded. It is an intracellular infection. They don’t know where he got it. Probably somewhere tropical, maybe out on one of his adventurous off the map camping expeditions. Nor do they know when. Months? Years? No way of knowing. Could have been sitting dormant for quite some time. Until it woke up, and started exploring its new home. It started spreading through small spaces, finding its way up to his blood stream and taking a ride up to his brain. It is a mercurial little devil; showing itself in odd neurological ways. Sometimes full body pains, sharp or dull, shooting vibrations down the limbs, sometimes he feels and hears things that aren’t there.

Worst part is, like most neurological diseases, its hard to diagnose. It took a few tries by a few different doctors to identify the bacteria correctly. But knowing it doesn’t make it any easier to treat. The only cure is to kill it, and that is proving rather hard to do. The medications have helped lessen the symptoms, but they come with side-effects.

What can I do when my new identity as a medical student proves utterly useless? I suppose to be the best patient advocate I can be, a friend who sits in the silence and listen when it is broken.

So for now we wait and hope for the miracles of modern medicine to prove itself once again.

Finding Dori

One week in and we are already sprinting. It took about two days to realize that if you didn’t know how to run, you better train your legs quickly, there is no jogging in this lane. To say drinking from a firing hose doesn’t due justice to the explosive amount of information we having pouring down on us. They didn’t waste any time jumping right into the details of artery this, muscle that, nerve this over here, all condensed in one sentence said on an exhale.

Nor did we wait for the infamy of dissecting cadavers.

Day four placed me over a body bag with five other lab mates and a scalpel in my hand. Her postmortem name is Dori. Short for Dolores. Inspired by the Latissimus Dorsi muscle. It is a superficial muscle of the back that wraps from the bottom of the scapula to the ilium crest. I think it looks like a corset holding it all in. And said in a Jane Austin British accent, Latissimus Dorsi sounds like polished ladies name. It seems fitting for Dori, a woman who painted her long fingernails barbie pink. I would like to think she was a fine woman. A woman like my grandmother for whom rules of decorum were not optional habits, but a lifestyle; one, at that, to be strictly inherited by younger generations. She would be the one to check for dirt under your fingernails and then offer you tea and triangle shaped sandwiches.

The process of dissecting another human body is an odd one. I have surprised myself with how unemotional of a process it has been. (Even more so by how meditative I find the slow focused process of cutting, probing, and clearing. While I pray I do not end up a surgeon, I can grudgingly admit to the appeal of practicing surgery; it is like a more practical form of jewelry making!) But then again, it is something I have thought about for a while, knowing my turn would eventually come. I’ve read, reflected, seen skits by other medical students about experiences in anatomy lab. These, for the most part, seem to have desensitized me.

But there are moments nothing can prepare you for.

Like carefully cutting away thin layers of fat on the cheek, concentrating so hard only to realize your nose has lowered just inches above her’s. Or when you are clearing the tissue from the back of the spine so you can saw it open and you think about how the chunks or muscle look like the shredded meat of your favorite tacos. Suddenly your sacred Mexican food is a bit less appealing.

One day the lab group is hovering over Dori. Our heads together as we poke and prod to identify muscles with their blood supply and innervations. Suddenly somebody let out a stifled scream. I looked frantically for something wrong with our work only to realize they were no longer looking down but at the counter behind us. A small cockroach was taking a stroll across our lab books. We began to freak out, arguing who would have to kill it. I couldn’t help but start to laugh. Here we were standing over a dead body with gloves soaked in formaldehyde and human excrements, clutching onto scalpels, scissors, and hammers, and what terrified us was not the body we were gutting apart but an inch long insect out of for a walk.

The irony of the situation was not lost on me.