Always Look on the Bright Side of Life

By Alisha Fernandes – Class of 2014

MF1 was only two years ago. Since then, I have gained a new perspective. A new paradigm. A new way of thinking. I savor the memories created along this journey so far and salivate at the promise of many more. I am thankful, and utterly inspired by my peers, teachers and by the patients who offered to teach me and my colleagues during some of the most challenging times in their lives.

One of the first patients I ever met was a British man in the cardiac care unit at Hamilton General Hospital. I’ll call him Ben. He was in his 60s, jovial, flirtatious, hilarious (in a Monty Python kind of way). He knew how to work an audience. Our clinical preceptors brought us to meet Ben because he was suffering from congestive heart failure (CHF). We spoke with him, awkwardly trying to cover all of the “routine questions” comprising a basic history. I remember peeking at his legs under the covers and seeing that he had quite a bit of edema. At that early point in time we really new very little about CHF, except that pitting edema was one of its cardinal features.

Ben kept us entertained for the better part of an hour, and even though we surely missed a few questions in taking his history, most of us felt reasonably satisfied with the information we had obtained – we even knew how many pets he had (2 dogs), and the destination of his last travel adventure (Belize). All important information from the checklist. We were proud of ourselves!

One question we had forgotten to ask Ben was if he had had any surgeries. He hinted to us about this misstep, and one of my peers then asked him about his surgical history. He told us that when he was 45 he had had a massive heart attack involving an infarct of the proximal left anterior descending coronary artery. He was fortunate to receive a heart transplant in London at that time – a new lease on life. He was proud to show us his big old sternotomy scar. Of course we all thought it was pretty cool.

Thinking back, we met Ben because he had been hospitalized.

He had been hospitalized because his CHF  becoming difficult to manage.

His CHF was difficult to manage because his second heart was failing him.

This progression was not clear in my mind back then. It was not until Ben passed away that I realized how ignorant I was regarding the terminal nature of his condition. At the same time though, that early naivety allowed me to learn things from my patient that I might not learn today. Ignorance is bliss…

Without all of the differential diagnoses and management options clouding my ability to see the big picture, I memorized something different that day. All I remember about Ben is his character and his inspiring outlook. In one hour Ben taught us about human resilience, humor, dignity, self-worth, hope, and acceptance. Lastly, as we were leaving his room that evening, Ben taught me to live without fear, because “if yuh don’t, you’re not livin’ life a’tall!”

Patients like Ben give me courage, inspiration, and a reason to strive to succeed as I march through clerkship at a dizzying pace. What a guy. For those of you Monty Python fans, I feel that Ben would have fit in quite well in the last scene of The Meaning of Life, belting “Alllllways look on the briiight siiide of life!”

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