Samantha Gogola, a third-year medical student at the Herbert Wertheim College of Medicine, shares her experience with a scared patient reluctant to engage with her. That all changed when she held the woman's hand. Gogola's narrative first appeared in Reflective MedEd and is republished with permission.
It’s pitch black outside and my alarm is blaring. Rubbing the crust from my eyes, I remember that it really is 4 AM right now, and it really is my first day of surgical breast oncology.
After gathering my compression socks, high-arch shoe inserts, fanny pack and a protein shake, I'm finally ready to leave the house. I try listening to Online Med Ed in the car but it’s hard to pay attention when I’m simultaneously trying to think of the questions I might get asked today. I park, chug my protein shake and head inside.
“Here you go,” the nurse says as she plops the heaviest patient chart in my arms. Suddenly, I'm glad that I was still an hour early. The words “ductal carcinoma in situ,” “BI-RADS 4,” and “sentinel lymph node biopsy,” flash before my eyes.
“I’ll go bring the patient in,” the nurse says. And then I see her. I can’t believe how young she is. Going back to her chart and quickly flipping through the pages and pages of pathology reports, lab results, imaging and histories I find it. My eyes go wide as I look back at her – 20 years old.
I continue listening as the nurse fills out the final consent forms with the patient and notice how, even though the nurse is speaking to her in English, she will only respond in Spanish. When I speak, she doesn’t even look in my direction or acknowledge my existence.
She disappears behind the curtain to change into her gown. The next time I see her, she is surrounded by so many people that there isn’t a spot for me next to her bed. As I am standing in the corner on my tip toes and craning my neck in a thousand directions, and through all of the coordinated hands and wires swaying above her like a symphony, I finally catch a glimpse. “Wait… is she crying?”
Someone leaves her side and I make my move to be beside her. I instinctually grab her hand and am surprised that she immediately squeezes it. Her breath is shaking as she tries breathing deeply. I'm looking at her trying to come up with the right words to say, everyone else notices what I see.
“Sorry that we had to stick you twice for the IV, but you can relax now,” says the anesthesiologist with a smile before he walks away. “It’s okay, this is a very simple procedure. You have nothing to worry about,” says the nurse as she pats her shoulder before following him out. “We caught this early, you’re going to be okay,” says the doctor as he shuts the curtain, leaving me and the patient alone. “How are you feeling right now?” I say, surprising myself in finding the words without thinking.
She grips my hand harder and looks up at me for the first time. “I’m just really worried about the anesthesia. I don’t like the idea of being asleep and not having control over my body.” As we talk, I can see her heart rate decreasing on the monitor. 102, 99, 96. The anesthesia team comes back and I continue to hold her as she is rolled to the OR. The symphony of hands and wires plays again as she is hooked back up to the monitors. 85, 81, 78. “Thank you, I really appreciated that,” she says as an oxygen mask is stretched over her face.
As I walk away to scrub in, I am amazed at the power of holding someone’s hand.
We've been told time and time again throughout our medical training that touch can soothe our patients, but I had no idea the magnitude of its power until this moment. This patient would not have felt comfortable with me or relayed her true fears to me otherwise. I don't know why this patient initially did not want me there to participate in her care, and my thoughts early on were centered on trying to figure out why this was. Was it because we were close to the same age? Was it because I do not speak Spanish? In the end, the reason didn't matter. Although I may have felt hurt at the start of the encounter, I made sure to remind myself of why I was there in the first place and to continue offering the best patient care and support that I could. This wound up making all the difference.