I was just walking through the hospital cafeteria after stealing an hour away from science to enjoy a quiet meal with a book (reading for fun). For a first year med student, it's a very strange thing to see a patient outside of an examination room. We have worked quite hard at developing this mask of professionalism, despite the fact that it still feels so odd to us. Personally, I work with a neurosurgeon that specializes in brain tumors. His visits often involve bad news and, despite the fact that sometimes I don't know it's coming, I like to think I don't flinch when someone responds to the news that they're going to die.
But there he was, sitting with his wonderful wife, just enjoying a light meal and discussing the VP debate. They were lovely people and he had been through a terrible time with cancer. They listening intently during the physician's explanation and the wife took notes, clarifying every time she didn't get something. This wasn't a pair of millionaires with a team of specialists across the country, they were regular people making the best of a bad situation.
When we caught eyes, I'm not sure if he immediately recognized me. One of the few rules I know is that you tell someone everything they need to know before breaking the big news to them - they glaze over as soon as they find out. I think that remembering the face of the med student sitting in the room probably goes along with that, but I digress.
I looked into his eyes and thought about his disease. I knew, from a biological perspective, his greatest flaw - for no other reason than to learn. I can only imagine what it's like to have others know about something so intimate, so personal. The easy example is erectile dysfunction - something you would never tell anyone you knew, but gladly offer up to a physician in a routine examination.
We are exposed to people's flaws, literally the biological errors occurring in their bodies. I have seen the inside of this man's brain and the tumor it maliciously supports. Be it the cafeteria, the grocery store, or the mall - we will see people whom we have more information about than most of their family members. Flaws include so much more than disease - a standard history includes drug and alcohol use, psychiatric issues, and sexual activity. If you cheat on your wife, it's extremely relevant. If you sneak out back for a smoke every day, it's extremely relevant.
At this point in my medical career, I consider it an amazing gift. I cannot meaningfully contribute to patient care, yet these people share with me. We all have flaws - deficiencies, mistakes, and errors. We get depressed, we use drugs and alcohol, we cheat, we lie. Our cells do the same - they stop growing (atrophy), they secrete drugs (paraneoplasm), they cheat (grow without waiting for signals), and they lie (breaking promises about cell checkpoints). Whether they be macroscopic or microscopic, we all have flaws. I sometimes wonder how honest I would be about my own flaws if a patient asked, let alone my own physician.
We cannot escape these flaws, we can only share them in hopes of fixing them.
