During our medical school training, we try to disentangle the Gordian Knot of the human body, and stand in awe of such a task – so many different pathways, and all missteps lead to illness. As we walked through our last Steps of pre-clinicals, we prepared for the transition into the wards. Starting my first day, I was excited, and anxious. I could imagine the beating of my heart, and I awaited the stories that would be etched in.
Red red.
The first day in the hospital was straightforward – an orientation to what will come. Lectures and expectations aimed ever higher. Walking through the hospital, the physical tolls on the patients were apparent. There were people in wheelchairs, people with altered gaits, and some who wore their diagnosis on their face. Shuffling, shifting, the patients stumble through the hospital. For some, the rhythm of their feet and coughs is drowned out by the moans and anguish of those who suffer. The crack of the cough, heard a thousand times, underscores the background noise. Red alarms can begin to lose their meaning. The patients’ stories are written into how they move, or in the psych ward, into their very minds. However, it is so easy to conflate the person and the disease. One patient, whom I saw and later admitted to our unit, underscored the importance of remembering every patient as their own person.
Red red. Red red!
These words galloped their way out of a small, frail woman. She was exhausted in her hospital bed, her sister at her side. As we walked into the room, this small woman barely turned her head to look at us. She was profoundly diaphoretic, her hair slicked back and body glistening from her frenetic pace. Frail arms, worn down by time, appeared trapped at her side – flexed but immobile. Her body appeared to not obey her will, and her arms had this waxy flexibility. As my resident introduced us to the patient and her sister, he bade me to try to take her history. I meekly introduced myself and asked how she felt. I then received a hail of red.
Red red. Red red. Red red.
My resident took over, asking the sister for the patient’s history and what happened. As we discussed the patient, she would look at us, and I stood there trying to understand the magnitude of what has happened to her. Her legs were still, hidden under a cover; no motion or activity. She peppered the red rainfall with the occasional “yes.” She once said the word helicopter. Looking out the window, we could see the Banner helipad with its barnhouse colors. Her sister had purchased a small cardinal red bear from the hospital gift shop in a desperate attempt to give the patient something to hold onto. The patient cradled the small bear, when her arms had the strength to hold it, but sometimes it was too much. She had an erythematous lesion along her left lateral arm which she tried to keep away from probing hands. As she lay in her bed, she was exasperated, her mouth belting out reds and consuming the remnants of her energy. Her head could barely rotate, and her body was stiff and noncompliant. At one point she saw my name and interrupted her streak to repeat it. I handed her my badge and she fumbled with the little thing. She wanted to say something, but it was drowning in the red sea. Her eyes hid a gleam of understanding, the tiniest spark of soul; however, they appeared clouded and unfocused. Her soul was held back by forces her mind could not conquer. As I try to untangle what was happening, my resident readies two syringes. One, a half a milligram of lorazepam, the other a saline flush. A gentle push of the syringes into the patient, and the miracle happened.
Red …. Red ….
She slowed down. Her galloping pace became a cantor, and something was stirring behind her eyes. As her verbigeration slowed down over the next 30 seconds, she began to look around more thoughtfully. She studied us in more detail, the alarm in her words subsided. Over two magical minutes, this woman who before appeared obtunded and trapped in her own world was able to reach out to us. She took my hand, and told me her name and how she was feeling. She introduced herself and her sister – tired but happy. Over the next 15 minutes, her control of her body returned, and for the first time in two weeks, was she able to carry on a conversation. She asked me about my name and who I was. I told her, and it was a great meeting. It feels so strange to meet the same person twice within the span of 10 minutes. She began to laugh and ask for things she needed, and asked us to be careful of her sore arm. Her eyes now danced across the room, absorbing the scene and opening wide with wonder. Beautiful eyes that shone bright, like the soul blazing behind them.
Mohammad?
I saw her again after the weekend. I was able to gather her history and really speak to her about what drives her and who she was. She was a woman born into a foster care system, who grew up through high school struggling with bipolar I disorder. She lamented the hardships of her youth, and channeled her pain into care for newer generations. She would put her all into something some days, and not others. She was not dumb, and told me she would sometimes try to get an A+ just to spite her detractors. In fact, the reason she chose the word red in her catatonic state was because she knew “code red” would symbolize emergency, and she was trying to communicate this with us. She felt anxiety and irritation at her inability to communicate, so she tried to sound the alarm. However, the marks of her condition followed her through life, as she struggled with coming to terms with herself and who she wanted to become. She chased life and sought out the love of a military man, but would be hounded by the shadows at the back of her mind. She would fight to become the most loving and caring woman she could be, and sometimes in the war of life, you lose a battle. She would occasionally lapse and require psychiatric assistance, but she always got up. She is the loving great grandmother to multiple children and wants to shower them with love. She dreams of seeing Hawaii once more with her husband to relive her happy memories. She loves to read history, and was a big fan of Muhammad Ali’s boxing career, which was why she reacted to my name when I originally saw her.
A patient is a story, and we read but a chapter in their life’s journey. She is not merely a patient, but a teacher of life’s many lessons. To care for her, helping play a small part in her care and being able to attend the patient’s needs is a reminder of the blessings that come with the practice of medicine. We work so that the soul can heal, the mind can grow, and the heart can love. No amount of reading could have prepared me for my study in scarlet.
Mohammad Khan is a fourth-year medical student in The University of Arizona College of Medicine – Phoenix, Class of 2021. He graduated from Arizona State University in 2014 with two bachelor's degrees in biochemistry and biology. He then worked as a teacher and completed a Master's in biomedical diagnostics in 2017. For fun, Mohammad (who also goes by Mokha) likes to practice at the archery range, work on calligraphy, game, and fountain pen writing, and read science fiction novels. He is interested in medicine with a focus on educating patients.