This piece by Laura Smith received an Honourable Mention in the Creative Writing division of the 2022 MIPS x Auricle Creative Writing and Visual Art Competition. Laura describes it as a “piece on uncharted waters as a medical student equipped only with the skills of two pre-clinical years.” This piece featured in The Auricle‘s October-December Edition in 2022.
“Presented with bilateral pulmonary embolisms. CT scans came in this morning and showed stage 4 lung cancer. She’s probably got about 6 months to live. If she’s lucky.”
“A walking ad for Quitline.”
Laughter from the team of respiratory clinicians.
“They should take her picture for the back of the box while she’s still alive.”
Medical students shadowed the doctors, lingering behind and doing their best not to get in the way. Struggling to find the situation humorous but not wanting to be impolite, Eloise halfheartedly attempted a smile.
Two years of textbooks and artificial clinical scenarios with paid actors hadn’t prepared them at all. Eloise thought of anatomy lessons, of the hours spent dissecting pungent corpses and appraising ‘specimens’- human body parts chopped up and laid out on tables.
Confronting was barely the right word to use after everything they’d seen in their first week in the hospital.
When the ward rounds were over, one of the younger doctors approached the students and suggested they visit the patient in bed 32.
“Take a medical history. Just ask her why she’s in here and make sure to have a listen to her lungs. Let me know what you find.”
Pacing the hallway just outside bed 32, Eloise wondered whether it was facetious to pry, poke and prod at a woman who had limited time left on earth and was faced with the task of accepting her own mortality. Her ward buddy grew anxious with her, twisting his stethoscope and inspecting it closely, as if to find moral guidance within its diaphragm.
“Can I help either of you?”
Brash and unforgiving, the ward nurse peered down upon the two 3rd-year medical students, her overbearing presence immediately quashing their ethical doubts.
“We’ve been sent by the Resp team to have a chat with Mrs Greenwood, are we alright to head in?”
Clearly unimpressed by their hesitance, the nurse let out an exasperated noise and nodded her head in the direction of bed 32.
Flowers drooped in the corner of the room, their presence gaudy and somehow melancholic against the harsh white hospital walls. A tiny television screen hanging from the roof was tuned into a reality show that Eloise’s mother would have described as ‘American trash’. Mrs Greenwood’s attention barely shifted from the show as the students introduced themselves and obtained her consent for a medical interview and examination.
Her bedside table was littered with empty food containers and medications, and a pile of books and magazines. Eloise’s attention was drawn to one particular title- ‘Turning a new leaf; how to embrace a healthy lifestyle!’.
“If you don’t mind Mrs Greenwood, could we turn off your TV for a moment to ask you some questions?”
“It’s June, dear.” The patient gave Eloise a warm smile as she switched off the screen and indicated for the students to continue in their history taking.
“First of all, could you tell us why you’re in hospital at the moment?”
“Well I’m still asking myself that. I was fit as a fiddle a week ago when I started noticing a sharp pain in my chest.”
“And your husband called an ambulance, is that right?”
“Yes, my Dad died of a heart attack, so of course that was the first thing I thought of. Lucky it wasn’t that! I had a couple of scans and apparently I’ve got clots in both my lungs.”
“And did they notice anything else on the scans?”
June didn’t notice the tremble in Eloise’s voice and the way her eyebrows rose and furrowed in strained sympathy.
“Nope. I’m all good. I’m on tablets to thin out my blood and I’ll be back home tomorrow. My husband’s coming in later today and we’re having a meeting with the doctors to plan my discharge.”
Eloise’s teeth clamped down on her tongue, a metallic taste filling her mouth and drowning the tears she felt rising in the back of her throat. Her fate would be revealed later today, in what hospital staf referred to as a family meeting. Mr Greenwood would have already received a ‘warning shot’; a purposefully ominous phone call instructing him to come in to the hospital immediately to discuss his wife’s health. Maybe there’d be others too; siblings, children, even grandchildren. They would all suspect something was wrong. But June still had no idea.
June said the whole experience in hospital had caused her to have a ‘health enlightenment’. Though distressed initially, she had managed to conjure optimism by committing to lifestyle changes she thought were probably long overdue.
“I’ll be quitting smoking, obviously. Don’t want anything else nasty turning up in my lungs. But I’m also taking the opportunity to start exercising more and eat lots of fruit and veggies.”
Blurry photographs crudely cut out and blue-tacked to the wall were almost unbearable to look at when Eloise entered the room, but now she refused to avert her gaze. Anything to drown out the fleeting hope of a woman on her deathbed. She wasn’t here to read the chapters of a book she already knew the ending to.
In medical school, they’d been warned against medical paternalism; doctors being accused of playing God, of defying patient wishes, of intervening in the natural course of life. Right now, Eloise felt close to divine power as she forced back the words that would bring an end to June’s world. Neither of the students could bring themselves to touch her so they thanked her and took off without listening to her lungs.
An elderly man, perhaps in his late 60s, wandered down the corridor with a bunch of mismatched flowers, roots still attached from where they were yanked out of the garden. Eloise thought she saw a glimmer at the base of his eyes as he turned and entered the room they’d just left.
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