On Intern Year

I have a smiley face sticker on the second “O” of DOCTOR written in big block letters on my hospital badge. An 11 year old boy with leukemia that loves to tell jokes gave it to me. I put it on my badge because I guess I find the fact that it says “doctor” pretty comical. I have to.

A few months ago I was a fourth year medical student, none of the responsibility with all of the glory. Now as an intern, I am expected to make the decisions, to take on the responsibility for human life and everything that it entails. I love my job. There’s honestly no greater feeling than going to work and spending your time meeting new people, hearing their stories, and trying to make their lives better. I loved it as a med student and I’m relishing in it now.

But as a med student I could hide behind my residents and attending. I didn’t need to have the answers, I was still learning them. Being a doctor is better than I could have ever dreamed, but the responsibility it carries is substantial. The patient is physically and emotionally  vulnerable with you, putting their wellbeing entirely in your hands. The emotion hits you full force too; there’s no med student mask shielding you.

I’ve had to tell multiple people they were going to die, multiple children that their mothers would not be coming home, multiple parents that their child’s intellectual state was the best it was ever going to be. It’s rough. But as much as it sucks for me, it’s excruciating for them.

All I can do is support them–to try to get appointments when the hospital denies their insurance and to use connections to get a specialists to hear their cases. But most importantly, I can listen. I can try to take a few minutes out of my 12-16 hour day, where I have endless notes to write, phone calls to return, and meals left uneaten, to hear them. To sit at their bedside and listen as they talk about how scared they are, vent about how frustrated they are with the healthcare system and cards dealt to them, and tell jokes to ease their suffering even if they laughter is for a few moments. My job is to allow them to be vulnerable with me in a way they cant with their loved ones since they have to put on a brave front. Because as tired as I am, they are exhausted.


Maybe I put the smiley face sticker on my badge because I don’t have the answers, and it’s my way of showing the world that I’m aware of it too. It eases the fact that I don’t have a fraction of the medical knowledge required to feel like a competent doctor. That will take experience. I don’t know what I’m doing most of the time, and I’ve said, “let me check with the doctor in charge and I’ll get back to you” more than I can count. It comes with the territory, we’re all learning.

But in moments where I sit by a patient’s bedside at the end of the day and we share a laugh or I try comfort them when they cry, I feel more deserving of my job title.


USC Med School Student Commencement Address

Welcome graduates, faculty, family members, and friends. I am extremely humbled to be here representing the graduating class of 2017. It is a tremendous privilege to deliver this year’s commencement address and I want to thank my classmates for selecting me. Though to be honest, I wish I had taken a beta-blocker before this because between Diandra’s 6 siblings and Tim’s triplets, we have a packed stadium.

I think that we can all agree that regardless of where we were in our lives when we started medical school, we have experienced more in the last four years than most people do in a lifetime. The first two years were dedicated to didactics, where we learned the science of medicine. We drudged through FML—I mean FMS—, organ systems, and gross anatomy. And we amassed an impressive collection of 8-pound binders of notes that are no doubt collecting dust in the back of all our closets. We sat through endless lectures and webcasts, and wondered if we’d ever see the light at the end of the tunnel. I think at some point we tackled infamous step 1 studying, but I’ve honestly all but blocked that out of my memory so I can’t really say for sure.

Then came third year and fourth year, our clinical years, and the first time that we felt we deserved our short white coats. We finally began to think of ourselves as student-doctors and got a glimpse into the art of medicine. We delivered babies, got yelled at for breaking sterile field in the OR (at least I did a bunch of times), and did way too many DREs for anyone’s liking.

The heart of our clinical years was rotating at the LA County Hospital. This institution is actually one of the main reasons why I chose to come to USC for medical school because we had the unique privilege of treating everyone that walked through the door regardless of who they were or where they came from. As students here, we were in the trenches of medicine, learning to advocate for the impoverished and to treat the marginalized with dignity. We witnessed the wide spectrum of the human experience, challenging our preconceived notions and introducing ethical complexities that have left us pondering long after the rotation was done. Working here has formed a foundation in each and every one of us that we will no doubt continue to build on in the years to come.

From ICM to MDL to NBME to ERAS to NRMP, we’ve mastered every combination of letters known to man over the last four years. But the biggest take away for me over our time together is the compassion and inherent kindness that characterizes you, my classmates.

Our class has seen more tragedy in the past two years than anyone should experience; we are missing two integral members of the Class of 2017 today, and I’d like to take a moment to acknowledge them. Sean and Colin will forever be entwined in the fabric of our class; their immediate physical presence is missed, especially today. The camaraderie and support we showed one another, the strength of their friends and loved ones, and the persistence to proceed despite heartbreak are some of the many reasons why I am proud to say that I am a member of the Keck graduating class of 2017.

This empathy is something that I hope we will all carry forth in our careers and that we continue to care for our future colleagues and patients with the same respect that we have demonstrated for each other. Compassion becomes real when we recognize our shared humanity. After all, the practice of medicine is rooted in understanding the human experience and using that knowledge to alleviate suffering. We are healers first and scientists second.


Whatever specialty you are pursuing, I encourage you to look at your patient as a whole, a novel in progress that you can help craft instead of focusing on the individual chapter of their life that relates to your particular field of medicine. The best doctors that I’ve observed, regardless of specialty, look at the psychosocial dynamics of their patients and they listen to their stories. Through cultivating trust they succeed in delivering treatment, and thus find daily satisfaction with their career. Every person you encounter has something to teach you. We should all strive to see our patients as people first and diseases second.

The trust that our patients and their families put in us cannot be understated. I am hopeful that we will continue to have the moral courage to do no harm, to put the patient’s best interest first, and to treat them as we would our family members. In an age where insurance companies, lawyers, and bureaucrats increasingly permeate the practice of medicine, I hope that we will be resolute in our reasons for pursuing this noble profession. There are very few careers where you can wake up every single day and take pride in knowing that that will spend your life helping others during their most vulnerable time.

But also remember that compassion extends beyond the hospitals walls and should also be directed inwards. Find balance even through the most grueling parts of your career; seek out moments of peace within the whirlwind of texture of your busy life. Learn to forgive yourself for your imperfections and, if there’s one thing you remember from this speech, it’s to find solace and support in your loved ones.

And to our loved ones, I want to say thank you. This day is as much yours as it is ours. Your unwavering support, constant encouragement, and sacrifices both financially and emotionally are as–if not more–valuable in helping us get to where we are today. Thank you for believing in us and our dreams.

I know I couldn’t be here without the support of my parents. Like many immigrants they struggled through poverty when they first came to this country, never losing hope, and ultimately succeeding through hard work and perseverance. I am where I am today because I stood on the shoulders of giants, giants who made countless sacrifices so that I could have every opportunity available. I know many of my classmates feel the same way when thinking about their loved ones and the sacrifices that they have made to get them here.
I want to give a special shout-out to my mom, who not only works as a successful Family Medicine physician, but somehow managed to take me, a child who couldn’t tell her left from right for an embarrassingly long time, and somehow raised me to become a physician and productive member of society. So thanks mom, you’re proof that miracles happen, and this speech is maybe proof that I don’t have to buy you anything for mother’s day tomorrow.

But in all seriousness, I am very honored to be graduating with the best class in the history of the Keck School of Medicine of the University of Southern California. USC, which I might add is the greatest school with the best football team in the entire world. Sorry Mansi, Omeed, and my other UCLA classmates. I had to.

Graduates, think back on the last 10, 20, or 30 years of your life. You’re no longer ‘trying’ or ‘studying’ to become a doctor. Soon enough you will walk across this stage and by some Hogwarts magic, become one.

Today we have the benefit of fancy robes and mimosas coursing through our veins to quell the quiet terror of beginning to introduce ourselves to the world as “doctor.” And what an exciting time it is. We have people going into all different specialties in a variety of locations across the US. I’m particularly thrilled that hospitals not affiliated with our medical school are about to get an influx of Keck graduates as residents, and will be transformed for the better. I truly believe that. We all have unique attributes and gifts that we will contribute; we are Arias’ little pumpkins after all.

I want to close with something my mom told me 6 years ago when I was struggling through Organic Chemistry and Physics, and I called her because I wanted to quit. She said, “Pre-med is like learning the alphabet, medical school is like learning grammar and syntax, and practicing medicine—well that’s poetry, that’s the next great American novel.”

I invite you now as newly minted doctors to go forth and write your story; I have no doubt it will be the most incredible works of art the medical world has ever seen. Thank you and congratulations.

On Regaining My Empathy

I’ve found that I get angry a lot, especially while driving in LA traffic. I’ve been cutting off cars and dodging between lanes to get ahead. I honk more than any human being really should and spew profanities like no one’s business. This is a new thing for me.

I was talking to an OBGYN resident a couple of months ago that said she had recently started yelling and honking at slow pedestrians in the crosswalk to hurry up. She supposed it was so she could speed home and get a few moments of a ‘normal’ life before she had to work again. She knew it wasn’t a good excuse but couldn’t help herself; she had become wired this way. It was a huge light bulb moment for me because I finally had an explanation for this sudden onset of road rage. Obviously I need to take personal responsibility for it, but there’s something to be said that it started over the last year.

We’re in a fast paced field, where we wear our 80-100 workweeks like a badge of honor. We try to out compete each other by bragging about how early we got into the hospital or the number of procedures we did that day. But I’ve found that I’ve become exhausted and numb (especially during rotations that challenge our circadian rhythm). How can you not be? It chips away at you. 12+ hours spent in the hospital and then you go home to study for the final exam. If you go out to do something fun that week, you really maximize it, which usually forces you to recover for most of the next day, and then back to work by 6 am. You may recuperate during an ‘easier’ rotation that is 30-40 hours a week and regain your sanity. And then you’re thrust into another crazy schedule again. And the cycle continues. You feel like a zombie going through the motions until you can find a night to catch up on sleep and feel something again.

Your patients don’t suffer, the quality of your medical practice doesn’t suffer, but you do. You throw yourself into your work, giving 100% of your empathy, intelligence, and effort into helping your patients that you leave the hospital with only a reserve tank to help yourself. Doctors and medical students have enough empathy and compassion for everyone but themselves. We hold ourselves to impossibly high standards that if any of us falter it’s better to make her an anomaly than to accept that she represents the otherwise silent norm.

I used to think that feeling overwhelmed in this field was a sign of weakness. We all knew what we were getting ourselves into and if you’re not cut out for it then maybe you’re in the wrong field. Suck it up or quit. But this mindset perpetuates the type of environment that has led to high rates of physician burnout, substance abuse, and suicide. This is the life we signed up for. I’m well aware and don’t think there’s a way to change it. But we can change the culture to one that is kinder to one another. We can be more compassionate and understanding of our colleagues not just our patients.

They say the lowest point of empathy in a doctor’s life is during their third year of medical school. I believe it. I used to pride myself on my empathy; it’s something I would list as one of my best three qualities. But I’ve found that it has eroded over time and is harder to draw on especially in my personal life. I get annoyed if I have to wait in a long line at the grocery store and get frustrated if things aren’t done quickly. I feel like my mind is going a million miles an hour and there’s always something to do. I’ve been fortunate to not have experienced depression or anxiety this past year, and have been really lucky to have great experiences overall as far as third year rotations go. And yet I still have felt beleaguered, frustrated and burned out. Maybe I’m alone in this, but I have a feeling it’s something we’re all going through but few are talking about.

I wasn’t willing to acknowledge it until recently. I thought that it was a rite of passage and these feelings would pass once residency was over and I began my life as a real doctor. Earlier generations had it much harder than us; my mom was forced to work 30 hour shifts as a resident when she was 8 months pregnant with me. Things have certainly gotten better, but there is much more work to be done.


A classmate of mine recently passed away and we had a memorial today to commemorate his life. While I originally wasn’t going to write anything because I felt that it was a personal moment within our community to reflect, I realized that a lot of my friends are in medical school and are likely experiencing something similar to what I mentioned above. Many of the speakers at the memorial, students and faculty, shared beautiful speeches with gems of advice that I’ve listed below. These ideas are not mine, but I felt the need to share them because they’ve made me reflect deeply and I want ready access to them the next time I feel overwhelmed or irritated:


  • It can be very difficult to recognize depression. People can be good at hiding it and going through the motions of being happy and sociable. Just became someone is smiling doesn’t mean they aren’t hurting inside.  We need to really listen to one another and work harder to reach these individuals. We also need to remove the stigma on mental illness. Depression, schizophrenia, and anxiety all have biological basis of disease like diabetes or rheumatoid arthritis. We need to treat them as such in all fields of medicine and be compassionate towards those that suffer from them, especially doctors.
  • We have to care for each other the way we care for our patients. Empathy should extend beyond the clinic walls and should not be exclusively reserved for patients. It’s time to stop the hierarchies and mistreatment of one another. Just be kind to other doctors and medical students. The work will get done either way, you might as well make it pleasant for everyone.
  • Take time for yourself. You cannot give to others if your cup is empty. It’s ok to be selfish and recharge. There’s a reason why they say to put the oxygen mask on yourself first before helping the person next to you on an airplane.
  • Don’t be hard on yourself. We’re all human beings which means we’re inherently fallible. Forgive yourself and learn from your mistakes.


I’m starting residency a year from now and will begin final training to cement the type of doctor I will be for the rest of my career. I’ve realized over the last few weeks that I need to make a change in my attitudes and perspectives towards medicine. I need to regain my empathy. I’m forcing myself to take time to slow down, be patient with others, and to not be so demanding with my colleagues or myself. And if the road rage doesn’t subside, I’ll blast meditation music on Spotify while I drive.

On Kids: A Lesson in Resilience

Going into a room 10-15 times a day and seeing a baby or toddler is the greatest feeling. Even if you spend the entire time talking to the parents, just being in the presence of something that cute is incredible. If you don’t believe me, imagine walking into a room with a puppy staring at you and doing weird shit. Now imagine doing that over and over again. And while you examine the kid (or puppy) you pretend you’re playing a game where the reflex hammer is a “boop” and your vibrating tuning fork is a “buzz.” And they giggle and dance with you, and all the while you’re checking their cranial nerves through their smiles and their strength through hopping with them. It’s literally magical.

Not only are tiny humans hilarious and unintentionally odd, but they’ve also taught me a lot about resilience. CHLA is a super specialized hospital, where all of the “zebra” cases that are tough to figure out and even harder to treat go. Kids with rare diseases that you read about in textbooks come here in droves to receive care from some of the smartest pediatricians in the country. And since I’m on neurology, that means that I see children with extremely heartbreaking metabolic, degenerative, and in essence incurable illnesses. Kids, who through no fault of their own, were born with things like seizures, paralysis, tumors, and developmental delays all in one because of some stupid genetic mutation on one stupid gene out of thousands and thousands. And the number of strokes I’ve seen in kids ranging from 2-13 years old is unreal. I never knew a child could have a stroke and in the past two weeks I’ve seen 6 of them.

Each time I ask the attending about what their lives will be like as adults, his face turns grim because it’s tough to predict, but for now, the children appear to be happy. They’re just kids who also have diseases.

They remind me of the kids I see at The Painted Turtle, a summer camp for kids with chronic illnesses that I volunteer at. There are kids with liver and kidney disease that takes dozens of pills a day and desperately need transplants, those with hemophilia who run to the risk of bleeding to death from a simple fall every single day, and children with skeletal dysplasia whose short stature makes them feel different from everyone around them, and yet if you spend time with them you realize that they’re all just normal kids. They’re children that happen to have illnesses, but they’ve found a way to adapt. They play with the same toys as kids without diseases, they enjoy the same movies and music, and they have tons of friends that don’t necessarily have chronic illnesses like them. Don’t get me wrong, their life comes with a set of unrivaled challenges compared to most of us, but for the most part they try their best to live regular lives.

One of the kids at The Painted Turtle, a 11 year old boy that was born without kidneys, told me that people constantly ask him if he wished he were ‘normal’. And this little boy, who undergoes dialysis for 12 hours every night and will need multiple transplants over his lifetime to survive, replied “I tell them no. Don’t get me wrong, sometimes I wish I didn’t have to deal with dialysis and the pills, but to be honest if I didn’t have this disease then I wouldn’t be the person I am today.” If you think about how selfless and courageous that statement is, it’ll hit you right in the feels.

I know I’m digressing a little from my experience on Peds Neuro, but being at the hospital has made me think about all of the kids I’ve met with serious diseases or situations. Whether it’s children at Wema, who lost their parents from AIDS or violence, or kids with illnesses with little hope for a permanent cure. This is their normal now and they’re not going to let it screw up their chance to have a childhood. As an adult, I’m guilty of sweating the small things and getting worked up if something in my life is thrown a little off balance. These kids have their whole lives turned upside down and they still manage to smile and jump and play with my reflex hammer with me. And working with them over the last few weeks has reminded me to do the same.

On Love in the Hospital

During the last few weeks on surgery, I’ve been thrown into an unfamiliar world where sterility is key, speed is essential, and doing anything remotely wrong will get you yelled at. Because of the high volume of patients we see and the complex surgeries that need to be done in addition to patient care, we often see 15-20 patients around the hospital in less than one hour. That’s about 3 minutes per patient including transition time to walk from one hospital floor to another. As you can imagine this offers little time to ask more than “have you had a bowel movement?” or “how’s your pain?” before we’re off to the next room.

While this has been hard for me because I’m all about those patient narratives, I’ve been following the same man for the last week and have realized what true love is.

Every morning for the last 6 days, I’ve walked into his room to pre-round (check on the patients I’m following before seeing them again with the entire team) around 5 am. The man mentioned above is in his 70s has metastatic cancer, and without violating any patient privacy, I’ll just say that he’s developed some complications from being in the hospital that are making him stay for the foreseeable future.

We don’t speak the same language and aside from asking him if his cough has gotten better or if he’s pooped (I mostly use hand gestures to get my point across with him), there’s not much I can elicit besides doing a physical exam.

While his vitals and labs keep fluctuating, the only consistent thing with him is that every morning at 5 am his wife is there. During the first few days, I would wake both her and her husband up when I came in, but for the last couple of mornings she’s been wide awake, showered, and reading the newspaper when I come in the room.

The patient is well groomed, covered neatly in blankets, and aside from his sputum-producing cough, looks healthy. This is deceiving though because this man is actually very ill, and in fact, we have other patients on the service with similar diseases that are disheveled and disoriented. His wife, meticulously dressed minus the bags that have formed under her eyes from restless hospital life, stands beside me as I do the exam and answers my questions in broken English. If I pull up his gown to examine his abdomen, she tucks it back in place afterwards, her hands moving gently so as to not hurt him. I’ve never gotten the impression that she’s trying to be controlling. Because she can’t do much medically for her husband, I’ve come to understand that she expresses her love through taking care of him.

She bathes him and helps him to and from the bathroom. She tucks him in at night and sleeps in the chair beside him so he can wake her if he needs anything. She holds his arm and helps him walk around the hospital floor so that he can heal faster. He ambulates at a snail’s pace, and yet there she is beside him, helping him to take baby steps and flagging down nurses to find out when he can eat food.

She’s his biggest advocate and despite the fact that there’s no end in sight, she continues to do this every day. Every morning she’s up before 5 am and every night she goes to sleep in the lumpy chair beside his bed.

She’s his rock and in some ways I think he’s her’s too. He depends on her but isn’t dependent. He’s her husband and my impression is that she intends to do her best to help him through this because that’s what you do. When you’re in love with someone, you’re there. No matter what. We think of love as being about flowers and love letters, but I think it’s being willing to cherish someone and to support them during their toughest moments. I’ve been fortunate enough to know love and can empathize with their relationship, but I also think that that this kind of love extends beyond the romantic.

I could just as easily see a parent doing this for a child or a sister for her brother. In fact I’ve fortunately encountered numerous dynamics like these in the hospital. We often think about the patients without considering the experiences their loved ones have as a result of their illnesses. I think these instances are perfect examples of what it means as human beings to truly love others. Hospitals can be depressing places where you see the worst that life has to offer, but if you open your eyes, you can also see the triumphs of humanity in the form of pure, selfless love. Moments like these make getting in and leaving work without seeing the sun worth it. They’re why I got into medicine.

That’s something to be thankful for.

On Psychiatry

During the first two years of medical school we were taught to ask everyone we interviewed about a history of physical or sexual abuse. I’ve fortunately never been abused, and erroneously believed that the prevalence was low so I would often skip over the question. I told myself it was because I didn’t want to make the patient feel uncomfortable, but to be honest I was afraid that the answer would be yes and I’d say the wrong thing. There was nothing I could do at that point as a medical student to help and I thought it’d be worse to bring up a terrible memory for the person.

To my shock, about 80% of the patients I’ve talked to over the last six weeks on Psychiatry have said yes to the abuse question. That’s not to say that people that have been abused exclusively go on to develop Psychiatric illnesses or that all Psychiatric patients have been abused, but the prevalence was striking. It likely would be just as high in other medical specialties because Psychiatric patients have comorbid diseases like heart disease, diabetes, osteoarthritis, etc, but this was the first time in 12 weeks of rotations that I’ve actually asked. I’m sure I’ve seen patients that have been abused on Family Medicine or Internal Medicine, but at the time I assumed that they would volunteer the information if they wanted help. Looking back on it now, that was a big mistake.

I was surprised when I realized over the last 6 weeks that I could actually help people that said they’d been abused. Talking about it, while painful, offered a cathartic release for many of the patients. We gave them medication to help with their flashbacks and concurrent depression or anxiety, and offered supportive therapy for them to deal with the consequences of their abuse. It was the first time since being on rotations that my job was to worry exclusively about someone’s mental wellbeing instead of viewing distorted cognition as a roadblock to treating someone’s medical illnesses. I love hearing people’s stories and I relished in talking to people at length to find out how their life has shaped who they are. I enjoyed figuring out how to help them and to provide support. Most importantly, I learned a lot about how to approach patients–there’s way more below the surface than their chief complaints.

Before this rotation, I honestly thought Psychiatrists only treated floridly psychotic patients with out of control bipolar or schizophrenia. I thought anti-psychotics were meant to dull the mind and offered little relief than to zap someone’s consciousness so the delusions would stop. But I’ve seen medications take people from the brink of psychosis, with little hope of functioning, to relative normalcy. It’s given people that have lost control of their minds, an opportunity to regain some function and live with autonomy. Anti-depressants and anxiolytics have helped people going through really horrible life situations the support to keep going.

I’m astonished by how prevalent mental illnesses are and how little they’re being talked about. I’ve heard a lot of really heartbreaking, messed up stories in the last few weeks. Narratives that consume the lives of the ones that wrote them are kept inside. People that you encounter every day at the store, in traffic, or in the classroom. No one is immune. It’s made me think twice whenever I get angry at someone driving slowly in front of me or am wary of the cashier that’s frowning in the grocery store. Instead of a knee jerk reaction to judge someone, I think about their story and how it’s shaped who they are today. There’s a reason for everyone’s behavior. No one’s an asshole for no reason, and understanding that has given me more peace and empathy.

I likely won’t go into Psychiatry, but it’s opened up a new world to me in regards to patient care. I won’t be afraid to ask patients the hard questions about things like abuse because mental health needs the attention it deserves.

On Death

Today my first patient died. I was directly responsible for her care over the past week, and she suddenly decompensated, was transferred to the ICU, and passed away.

And I’m writing this because to be honest I don’t know how I feel. I think it’d be easier to turn on Netflix and eventually drift off to sleep, letting this be a blip in my memory that’d eventually fade away. But since death will inevitably be apart of my career, whether at my hands or others along the medical food chain, I need to reflect on it. Because I know myself and if I don’t then avoidance will turn into habit and then it’ll become a fact. And I don’t want death to be a given.

If this had happened six weeks ago at the beginning of the rotation, I’d likely be broken up over it. Coming off a clinic rotation like Family Medicine, where I didn’t deal directly with rapidly deteriorating health, I would have been distraught over losing someone under my care. And yet, after spending 6 weeks at the County Hospital, a tertiary center where the sickest of the sick and the poorest of the poor seek refuge (not surprisingly, two categories intertwined), I’ve seen things. I’ve taken care of patients with terminal cancer, with worsening cirrhosis a heartbeat away from death (i.e. the patient that was the impetus for this post), with debilitating autoimmune diseases, and with infections that you normally read about in obscure textbooks.

I’ve witnessed what happens when poverty and poor life choices devour humans leading to HIV, Hep C, cirrhosis, and a slew of other diseases in one degenerating body. It’s heartbreaking and frustrating to see. And yet, everything happens for a reason and you need to constantly remind yourself to keep your compassion because you don’t know the full story (which is easier said than done at times). I’ve also seen people that wake up one day, feel bad, come to the hospital and learn that they have terminal diseases. No warning, no obvious risk factors. Normal people like you and me who get up and wish they had stayed in bed when they find out that they will die soon.

And what strikes me about the death I experienced today is that it happened to the first group of people. The people that “did it to themselves.”And what’s tragic is this story isn’t a HIPAA violation; it happens so often that you’d be hard pressed to pick this patient out of the scores of people that share a similar fate each year at County. I guess my question is, does that make it less sad? Does that mean we should have less compassion?

It’s easy to criticize my patient for drinking an absurd amount of alcohol for years. For neglecting to take care of herself to the point that her teeth were rotting and her extremities were swollen from the liver failure. And yet she was pleasant and funny and had a daughter that cried at her bedside as she physically and mentally deteriorated. And when you humanize her, it makes her death more emotional and the sad feelings set inThere really is no right answer because being distraught is distracting and as a doctor you have to take care of a lot more people and being torn up over one patient, no matter how tragic, affects the care of dozens.

A close friend of mine responded with something incredibly poignant that I hope it will help my student-doctor friends or just people that deal with difficult situations at work: “If you don’t feel like you’re feeling enough, it’s ok to take care of yourself because your patients are depending on you to think clearly and to have the best plan for them. If you empty your own cup you wont have anything to give.”

I haven’t achieved the balance yet, but by writing this post at least I’ve recognized that I can work towards it.