After Peter's heart wrenching reflection last week about a colleague being shot, this reflection from one of our senior medical students at UMMS seems timely. I share with you what her assigned faculty member for her family medicine rotation wrote to me (from Katharine Barnard, Director of Plumley Village Health Services):
Hugh, a couple of weeks ago I had the pleasure of working with Lauren Hall, MS3, during a patient care session at clinic. One of our afternoon patients was a young woman being seen for followup after a hospitalization for injuries due to an accidental gunshot wound. By the end of the visit, we had all shed tears – the patient, her mom, and all of us in the care team – but I also left the visit with something positive, a deep sense of respect for the strength of the human spirit. I found myself reflecting on the experience of trauma and recovery, on maintaining dignity in the face of serial setbacks or inequalities, and on the sheer will to live that keeps us putting one foot in front of another even when we can’t imagine how we are doing it. Lauren wrote this reflection afterwards, which I felt perfectly captured the mixed emotions of sadness and respect that we experienced. With her permission, I am sending it for consideration for the Thursday Morning Memo.
Send comments to Lauren at Lauren.Hall2@umassmed.edu or to the list serve directly. Enjoy.
23yo F, GSW to the Leg, Day 13
At first, the term 'gunshot wound' was exciting… this was the first time I’ve seen anything like this. When I entered the room, I was caught off guard by how young the patient looked. She was 3 years younger than me. She had a large bandage on her leg and was wearing a short dress to prevent any pain that pants or shorts might caused. She and her mom were visibly hesitant to talk to me, but I persisted and began asking questions as usual. She began to tell me a little bit of her story. She was living at a shelter with her 6-month-old son. Her room is on the second floor, but now she can barely get onto the exam table without the help of two people. She told me how she spent two days in the ER and was sent home with a prescription for Motrin 800mg TID. I couldn’t help but wonder why I received 60 Vicodin after a simple shoulder procedure, but she received Motrin. The medication was clearly not managing her pain —she was miserable and immobile.
It has been a week and a half since the shooting and she has struggled to take care of herself and her son. She told me how on several occasions she could not even make it to the bathroom on time. She relies on her mother for bathing and struggles to dress herself. Through all this, she didn’t want to ask for help. She pushed through, trying to maintain her independence and to not be a burden on others. Her strength and determination was obvious. She explained that if she left the shelter, she wouldn’t be able to get her own apartment in the future. I appreciated her drive to remain independent, but couldn’t help but feel that her care and her health were suffering due to her socioeconomic status and the stigma surrounding her injury.
Eventually, Dr. Barnard asked her about how she was dealing with all this and she began to break down crying. It wasn’t just an interesting gunshot wound — it was a traumatic event that will likely have long lasting side effects on her mental health. Today’s visit may not have fixed her medical condition, but it will hopefully give her the ability to continue maintaining her independence and provide for her son. I continue to be amazed by the strength of the patients that I have seen in the past two weeks on my Family Medicine rotation, and this patient was a perfect example of both the strengths and failures of our medical system.
The Thursday Morning Memo is intended to complement the Monday Memo and usual list serve communication by providing communication of "clinical success stories" within the Department. Feel free to post responses to these stories on the listserv, realizing that they will first be directed through Hugh Silk, the Thursday Morning Memo moderator. Please note that all submissions, original stories or responses, must be free of HIPPA identifiers to preserve confidentiality.
If you wish to submit an item to the Thursday Morning Memo, please email it to Hugh Silk. Please write the Memo as a short essay, reflection, poem or story about your clinical/teaching success (keep it to one page). Please de-identify the patient or learner. Please ask the patient or learner if it is OK to write about them.
June 15, 2017 - Potrero Hill by Peter McConarty
June 8, 2017 - An Unnecessary Burden by Anonymous
June 1, 2017 - You Can Always Treat the Scabies by Hugh Silk
May 25, 2017 - New by Ginny VanDuyne
May 18, 2017 - White Coats and Black Magic by Supreetha Gubbala
May 11, 2017 - Finding Light Amidst Darkness by Anna Chon
May 4, 2017 - Heartfelt Advice by Emily Yan Yuan