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Lessons from my first patient

I met my first patient about a month into medical school, at a point in my education where I had learned some simple terms but certainly had built nothing close to the literal and metaphorical body of knowledge one accumulates over four years of studies. Upon entering the exam room that day, I nervously introduced myself to my patient and declared that I would be working with her. And then I opened the bag to reveal the body.

My first patient had died the previous year due to complications from metastatic cancer. She was one of approximately 25 people who had donated their bodies so that my medical school classmates and I could visualize the basics of anatomy and physiology in person. Ever appreciative of this gift, my labmates and I treated our donors like living patients, addressing them by their names and sometimes even explaining what we were doing to their bodies as we studied them in anatomy laboratory over the course of a year.

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The first visit with my first patient was jarring: her skin glistened but was morbidly pallid; her body parts were intact but lacked the vigor of life. Over time, however, as my classmates and I cut into the bodies, the exercise became more academic; we sought to identify vessels and nerves that would be relevant in our clinical careers, and we memorized the myriad muscles and structures.

Still, during anatomy dissections I thought often about my patient’s life. When I identified the dorsalis pedis artery on the feet in the location where doctors feel for the pedal pulse, I wondered where in the world those feet had traveled. During a dissection of her brain, I pondered what sorts of memories were hidden in the folds of the pliable cerebrum. As I held her hand and identified the muscles that move the fingers, I thought about the hands she must have held in her lifetime.

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I also wondered how my patient had died, not so much about the mechanics of death but the circumstances of it.

Did she pass away at home surrounded by family or in the hospital with the impersonal machines we use to keep people alive? Was her death as painless as possible? I pondered what sorts of regrets, if any, she might have had and whether she had made peace with the notion of her impending demise.

A few days before meeting my first patient, my classmates and I had a discussion with three community members who had committed to donating their bodies to the medical school after they died. One of them, a former physician, asserted that medical school is excellent in training physicians who can prolong patients’ lives. Despite that success, he said, medical school does not adequately teach students about death, and the anatomy lab is the one place where students have the opportunity to confront mortality in an understanding yet impactful environment.

Some medical schools are transitioning away from even that exposure to death and now have students work with models and virtual anatomy tools. While such an approach certainly fulfills the stated objective of educating students about anatomy, it deprives them from the range of feelings one faces when seeing and working with a body donor.

Much more than the origins and insertions of various muscles or the course of vessels, my experiences in the anatomy lab indelibly remind me that it is a privilege to help heal patients and that each patient is someone’s child, parent, and partner.

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A couple of weeks after the end of my anatomy lab course, I met my first living patient at a nearby family medicine clinic. I remember entering the room nervously, introducing myself to the elderly woman who was waiting for me, and conceding that it was my first time working at that specific clinic.

Somewhat jokingly, she commented that she hoped that I had worked with other people before her. “Yes, I have,” I responded, as I recalled my first patient.


Sathvik Namburar is a medical student at Dartmouth College in Hanover, NH. He can be reached at sathvik.r.namburar.med@dartmouth.edu.