An Elemental Experience in Medicine

This blog post is the third in a series of posts written by students in our new Longitudinal Integrated Clerkship (LIC) at Hudson Headwaters Health Network. Read previous posts by Holly Bachilas ’19 and Sunit Misra ’19.

uvmmedicine blogger Khaled al Tawil '19
uvmmedicine blogger Khaled al Tawil ’19

As a student in the Longitudinal Integrated Clerkship at Hudson Headwaters Health Network, I have the opportunity to get to know patients over the course of an entire year. I’ll accompany them to check-ups, tests, surgeries, rehabilitation – any interaction with a health care provider is considered a learning opportunity. Not only do I experience the health care system from multiple angles, I begin to understand what it’s like for a patient to experience sickness and health.

A short time after beginning the LIC program, I met a patient I will remember for the rest of my life. Let’s call him Jim.* A retired farmer, Jim woke up one morning with a leg that had turned red. The Urgent Care diagnosed it as cellulitis, but after his condition quickly worsened, it became clear that the infection was much more serious. Necrotizing fasciitis, a sometimes fatal infection that has the potential to spread rapidly, was the culprit behind the dreadful rash. With incision, drainage, and debridement the best emergent treatment for this condition, Jim was admitted to the hospital, which is where I met him.

In the weeks after his initial diagnosis I accompanied Jim to many surgeries, assisting in some and observing in others. I would visit him the morning after surgery to answer questions and provide company in the lonesomeness of the hospital. Jim nodded and spoke in short sentences as he was on a painkiller throughout most of his stay, pressing a green button whenever he needed another dose to numb the pain from his infected limb. I met his brothers, nieces, and some of his friends. I learned that he meditated to pass the time and cope with his burden.  Some days he would be bright and excited that the worst of it was over, and others he would be gloomy and anxious about the possibility of losing his leg. Although Jim experienced multiple, serious complications, including hospital pneumonia, elevated liver enzymes from total parenteral nutrition feeding, and frequent urinary tract infections, he eventually overcame all of these challenges.  After his skin graft and toward the end of his stay, Jim started physical therapy. Although sometimes blood would rush to pool in his leg enough to turn it dark purple, Jim wasn’t daunted by the challenge. He saw in rehabilitation hope for his future.

The LIC allowed me to accompany Jim through his experience in surgery, in inpatient care and in physical therapy. I got to be a part of Jim’s journey to recovery, both in body and in spirit. During my four years of medical school, I want to experience and understand the patient voyage in this intimate way, and the LIC is just the right place for such an elemental experience in medicine.

*Some details have been changed to protect patient confidentiality.

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