Day 18: The Most Important Lessons From Residency, Lesson 3

I am to tell you of a time when I felt passionate and alive.  This is how I discovered my calling.  My apologies for the lack of details in this post.  I do have to protect my patient’s confidentiality, even though I no longer care for him or even work in the same city.

A little boy arrived in the city where I trained and was brought from the airport directly to our emergency room because he was so ill.  He had just journeyed from a refugee camp in a small developing nation (French-speaking) where he had lived his entire life.  His family was from another neighboring country and fled because of war.  This boy and his two siblings were born in the camp.  During the process of their immigration to the U.S., this child was diagnosed with a very serious and potentially fatal condition which became active at some point during their journey.  He was admitted to the hospital, thin, fevered, with terribly painful swellings in most of his joints.  I wasn’t working in the hospital at the time, but knowing my interest in international medicine along with my earlier study of the French language, the hospitalist invited me to meet him and his family.  I was overwhelmed by their need, arriving in a foreign culture, speaking a foreign language, attempting to understand the repercussions of having a child with a very serious chronic illness all in a place that is completely unfamiliar in every way.  I stumbled over my French (rusty from over 7 years of disuse), eventually warming up to recall enough vocabulary to speak relatively competently.  I managed to learn some details of this family’s life and communicate a few important details when the staff interpreter was absent.  This boy’s parents shared some of their life with me.  When I asked what his father did for a living, he told me that for the past 9 years, he had begged and searched for food.  When living in a camp, there’s no place to work, no way to sustain a family.  His mother was so worried about E, not sure if he might live or die, unsure whether medications might help or make him worse.  His two younger siblings were happily oblivious to all of this and excited to make new friends.  They loved when we brought ice cream up from the freezer in the ER for them.  I brought some children’s books en francais that kept them occupied during long hospital days.  I burned CDs of French music that I had on hand and brought books from my French lit classes for mom to read and pass the time.  I was honored to have this role, one of friendship and not of medicine.  Since I was not responsible for his medical care while he was hospitalized, I was free to sit with this family and talk.  Poor E was terrified.  He received blood draws, shots, procedures.  He awoke from sleep screaming and thrashing, and during the day, he remained quiet and sullen most of the time.  I thought for awhile that he had given up.  A medical student, James, on the inpatient service made a particular impression on this boy, and I enjoyed so much watching little E learn to high five and wrestle and do all of the things that little boys should do.  James took him outside, played soccer with him and taught him to yell.  James did what none of the rest of us could do.  He brought this little guy’s spirit back.  After his discharge, I had the privilege of caring for this child and his siblings in our clinic along with several other refugee families.  We wrestled with a number of complications, and I relied heavily on discussion with specialists to form treatment plans, but he improved steadily, and by the time I left, he was thriving.

I wrote this confession not long after meeting this dear boy:

“I completely fell apart when I got home on Friday night.  My heart is overwhelmed by this family.  I don’t really mind that part so much.  What frightens me is that I think I might want to take care of children like E all my life (French-speaking and all).  I’m not really sure what that means for me yet, but I’m beginning to think I should stay in residency for a few more years.  I have so much more to learn.  Needless to say, I am feeling a little bit too contemplative this weekend.  You didn’t tell me that when I encountered the developing world that it would grab a hold of me like this.”

I’m still working out what this all means for me.  I do want more training.  I completed a 2-week international medicine training course which was phenomenal.  I met so many like-minded individuals there, some who have been missionaries for years, others who are, like me, just beginning.  I still keep in contact with many of the professionals that I met at that conference.  More intensive training will take much more time though, and I don’t know how to work that out.  I’ve thought about pursuing an MPH.  Most programs that emphasize the areas that I am interested in are out of state and available to me only online.  The challenge of getting a masters-level degree while working and parenting two toddlers just feels like too much (particularly with the $36,000 price tag I was quoted for one program).  I’d love to learn some more tropical medicine.  The course I’m most interested is in London and lasts 12 weeks.  How to get to London for 12 weeks with 2 small children and continue working?  I just don’t know.  I’ve studied up on missionary organizations.  I think I may have even selected one, but I still don’t know how to make the transition from this life to my next life to fulfill this calling.

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