MD Candidate, 2015, Michigan State University, College of Human Medicine, United States (Fall 2014)
*Note: All characters and events are fictional.
A sliver of dawn snuck beneath the blinds and stretched across the floor to where I stood, illuminating the pale, white tile. In the middle of the room, curled beneath a pile of covers, a young girl inhaled a deep, heavy sleep. The advancing light revealed a slight figure on a vast mechanical bed, her lips dry and cracked, her scalp colorless. An intravenous (IV) pole towered nearby, the infusion pump producing endless bars of sterile beeps, a hospital symphony. On her nightstand were a small notebook and binoculars, and perched on the windowsill was an artificial flower. Sunlight met the petals, emitting a soft, purple glow that began to fill the room with hope.
“Steve,” my attending, Dr. Hurley, said behind me. Sitting at the nurses station on the pediatric floor, I was engrossed in my patient’s laboratory results on the computer. “Hey Steve,” he repeated. I turned and he met me with a slight nod. “Let’s round, buddy.” Before I could interject that my name was not Steve, he was halfway down the hall.
I caught up with him outside the door of my patient, where the rest of the team was waiting. Dr. Hurley gestured for me to begin the presentation.
“If you would do the honors, student doctor Steve.”
“Sure, uh…seven year-old female, admitted last night with high fever for one day, and everyone probably knows she has…”
“Steve,” Dr. Hurley cut in, “I read her chart, just tell me how she’s doing.”
“Well, I didn’t actually talk to her because she was sleeping, so…”
Suddenly, in a single motion, Dr. Hurley turned, knocked on the door, and swept into the room trumpeting, “Hello hello!” and by the time the rest of us filed in he was sitting cross-legged at the foot of the bed.
“My dear,” he hummed, his hand resting atop the blankets covering her legs, “how are you?”
The blinds were open and the room was bright. Standing behind a huddle of residents, I observed the interaction through a cluster of heads.
“Ok I guess,” she replied, wearily. She exposed her arm from beneath the covers at Dr. Hurley’s request, and he placed his hand on hers for a moment of reassurance. He then maneuvered himself to examine her, looking, listening, feeling, before squatting beside the bed.
“Rest, and dream of a healthy you,” he urged. “Regain your strength.”
The next instant, we were shuffling out the door and to the next patient.
Outside the hospital, the spectrum of fall was nearing its end, a few stubborn leaves still clinging to their branches, and even beneath the midday sun the morning chill could not be lifted. The following day I found myself standing outside my patient’s door, looking out a nearby window at the expanse of scenery afforded at the tenth floor. There were others down that corridor too, patients, their dreams and imaginations ebbing and flowing with the days. I recalled the finesse Dr. Hurley displayed in his interaction with my patient and others – deft, and artful. I knocked and entered.
She sat cross-legged in the middle of the bed, her posture exhibiting a Zen calm. Resting on her lap was breakfast, untouched apart from the missing corner of a pancake. The hospital gown hung loosely from her shoulders. Now displayed on the windowsill were a handful of artificial plants surrounding the flower I had seen yesterday, some a few feet high with big drooping leaves, a few spilling vines down toward the floor. I seated myself next to the bed and introduced myself, explaining my role as a medical student. She stole a look at me, then resumed poking her food.
“I heard you come in yesterday morning,” she said self-assuredly, belying a tone of youthful innocence. “I know the sound of your shoes, and your limp.”
“Is that so?” I replied, transcribing her vitals from the monitor. Her fever was gone, but her underlying prognosis remained grim. I was surprised by her energy, and in part, sensed an innate courage through her mood. It reminded me of her history, that she had been with foster parents since her grandmother passed away, and before that, lived with her mother who was now incarcerated. And, she was dying.
“Oh yeah, I’m really good at observing stuff,” she smiled, turning toward me.
“So, what kinds of things do you like to do?” I asked benignly.
“Hmm,” she thought, tapping her chin. “I like to explore! Well, I haven’t really explored yet,” she said disappointingly, “but I want to explore the rainforest, the desert, and the ocean. Then I’m going to draw it all in my notebook and make a book!”
Abruptly, the piercing beep of my pager suspended our conversation. It was the senior resident, so I stood and began making my exit.
“You’re going to need lots of energy to explore,” I said, motioning to her breakfast. “I’ll be back in a little while.”
It was the second clerkship of my third year, and for untold weeks sleep had proved elusive. I would wake in the early morning, thoughts racing from the pressure of determining if pediatrics was really for me, to nostalgic memories of volunteering in the Ecuadorian cloud forest, to trivial matters, like how often I should water my indoor plants in the coming winter. I felt the days becoming slippery in my grasp, reality at times but a hazy mosaic of soft edges illuminated by artificial light. But the next morning held a merciful calm, and on my way to her room I found myself listening carefully for a discrepancy in my gait.
Her notebook lay half-open next to her, where she had sketched what appeared to be a tropical rainforest. To my surprise, her windowsill was now full of artificial plants, with the addition of ferns and others with expansive leaves of alternating shades of dark and neon green. Even in the scattered daylight streaming through the foliage she appeared pale, her fever having returned overnight. She opened her eyes as I sat nearby.
“The plants,” I inquired, pointing to the window, “where are they from?”
“Mm, I don’t know, but I like them,” she mumbled, closing her eyes again.
This was the first time I had noticed how sick she was. Her dark, sunken eyes plunged in above her puffy cheeks, and her scalp resembled an arid landscape, with just a few, lonely hairs sprouting. I thought of her in the image of my mother, who had passed away a year earlier, lying in a hospital bed deteriorating, but hoping.
“Do you think about your mom?” I asked reflexively, causing me to regret my query. But she immediately perked up.
“All the time!” she replied, sitting up and wincing. “I know she did bad stuff. But I wish she was here.”
“Well,” I said, wanting to switch the topic for fear of delving too far into myself, “I’m sure she’s thinking of you, too.”
She offered a quaint smile.
“Weren’t we talking about something yesterday? Adventures? Exploring?” I recalled.
“Yeah!” she exclaimed.
“You said you wanted to see the jungle, and the ocean?”
“Right, so how about we get you ready for your adventure. Where do you want to go first?” I asked.
“Into the jungle!”
“Ok, first, you’re going to need to think about what supplies you’ll need, then think about what types of plants and animals and other stuff you might see,” I advised.
“I have my notebook and binoculars,” she said confidently, “and the other stuff I already know!”
“Ok!” I laughed.
She threw up her hands in excitement and proclaimed, “I’m ready to go!”
I awoke in the middle of the night, alert, unable to fall back asleep. Outside, amidst the darkness, an odd energy beckoned me to the hospital. I found myself driving through the cold silence of pre-dawn, wondering about my patient. What thoughts passed through her head when she was alone? How much insight did she have into her condition? Was she sad? What hopes did she have?
The nurses station on the pediatric floor was dim and empty, and upon loading the patient census, I was mystified by the absence of her name. I manually searched her past hospitalizations, which to my stunned surprise, listed her most recent admission as over a year ago.
“What?” I breathed softly.
Jogging down the hallway reminded me of chasing after Dr. Hurley, but now the corridor seemed increasingly narrow, veiled in shadow. Her door was closed, and as I stopped to listen for the repetitive tone of her infusion pump I could see the ascending dawn out a nearby window. But placing my ear to the door, I heard the inexplicable medley of animal and insect calls. I pushed open the door and was greeted forcefully with a rush of air, not cold and crisp, like the outside, but warm, humid, and earthy. Her bed was deserted, covers thrown aside, IV lines detached, the nightstand empty. In the windowsill was an implausible abundance of vegetation. There were giant monsteras and palms protruding this way and that, hanging heliconias, bushy ferns, and thick, weaving vines stretching across the floor to where I stood.
BENJAMIN LI, BA, is a fourth year medical student based in Flint, MI. He grew up in the Midwest and studied Sociology at UC Santa Cruz. His writing is inspired by Daniel Pinkwater, Kurt Vonnegut, and Cormac McCarthy, among others.
Highlighted in Frontispiece Fall 2014 – Volume 6, Issue 4