“Rebecca Lauwers shares a reflection written during her first year as a medical student.”
My first patient encounter of medical school occurred two days before the winter holidays. I spent the day in child and adolescent psychiatry. The parents have lingered in my mind the most. Sometimes they seem more haunted than the patients.
I keep thinking of one mother in particular. She was looking for answers to questions she couldn’t bring herself to ask outright. She would sidle up next to them, like she feared the answers, but not more than she depended on knowing. The unspoken questions like, Is my child Good? Is there something Wrong with her that goes beyond the sadness and the suicidality, beyond the rage?
With her face she said, Alright, we can call all these things some sort of normal, we can find a way to bear them, just as long as she is not Bad, in those unspeakable ways…
With her words she said, “She never really seemed to care for her siblings…”
Scared mother. Gentle mother. I let her become vivid to me. She looked far away, sifting memories the way she did on many drives home, through countless sleepless nights, stowed away for a meeting when she would get to talk to The Doctor, the one she hoped would Know. Trying to make sense of why everything is the way it is now. I felt deep respect for her, imagining this woman bent over her entire life looking for answers. Back-breaking work brushing dust away from fossils.
When we spoke with her daughter later that day she begged to go home. She started the meeting composed, almost poised, presenting what could be mistaken for a reasonable plan. But her rational defence devolved quickly into angry demands and tears. I wondered how you can make decisions about peoples’ safety when you don’t know them at all. What do you do while you are still building the relationship? How do you know what they need.
It snowed hard the whole day, so hard that a few outpatients cancelled. I drove home slowly, wondering what exactly I had done to end up in this position: the witness; the learner; the one with a refuge, but also access. It means nothing is asked of me. Does it mean there is nothing I can offer?
I know this is the process, the very way I will learn how to make these calls.
But I must pause to acknowledge that these aren’t just stories to be passively consumed, even though I am the observer. These are lives that continue on when my placement is finished and new experiences layer themselves atop my memories. They continue on while I am standing in the anatomy lab on a Wednesday morning, pushing the buttons on the coffee machine, sitting under a Christmas tree listening to my own lungs.
They don’t want to live so they take too many pills. They don’t want to die, so they call the ambulance themselves. They say “Don’t turn on the sirens, I will meet you outside. My brother will be scared.”
They want to know how to help their child.
They want to know how to help themselves.
I want to know how to help them.
We all have much to learn.