D. Micah Milgraum
It's a typical chaotic day on the hospital's hematology and oncology floor. I'm sitting in a side room with one of my fellow medical students, doing paperwork and making follow-up calls for our medical team.
That's when the music starts. The sounds of two guitars, a tambourine and a few maracas drift down the hallway. I can't make out how many people are singing, but the happy voices and the song's upbeat tempo make me curious: I never thought I'd hear this type of music on the "cancer floor."
As I look up in surprise, Kevin, our team's intern, appears in the doorway.
He catches my eye, and after a moment, we both start bobbing our heads to the beat. He makes swaying motions, as if he wants to dance.
The other student and I smile. It's startling to see our usually solemn intern--a tall, broad-shouldered man in a long white coat, a stethoscope dangling from his neck--break out his dance-floor moves. Clearly, Kevin doesn't realize how silly he looks.
After a few seconds, he stops.
"That's coming from Mr. Henry's room," he says. "You know, the really sick guy."
Mr. Henry, a husky, sixty-two-year-old man, was admitted a few days ago with a six-month history of mysterious night sweats, fevers and vague chest pains.
After running a number of tests that hadn't revealed much, we'd needed to do a bone-marrow biopsy. Our attending, Dr. Tameah, had used the opportunity to teach Kevin the basics of antiseptic and draping procedures as well as the biopsy technique. I'd joined them to observe.
As he watched them setting up, Mr. Henry was clearly very nervous.
I took his hand.
"I'll be here with you through the whole thing," I said. "You can squeeze my hand if you need to." To distract him, I asked him about his family. Eagerly, he told me about his children and their accomplishments, squeezing my hand every few words, but talking through the pain.
A few days later, we learned the biopsy results.
It had been the end of a long shift, and I felt anxious to go home, but then Dr. Tameah encouraged us to join our team in the pathology lab to discuss Mr. Henry's biopsy results. I reluctantly went along.
We listened as the pathologist explained the various procedures and stains she and her team had used on Mr. Henry's specimen.
"Mostly likely," she concluded, "he's suffering from a very rare form of acute myelogenous leukemia. It's aggressive, and probably terminal."
Disheartened, we followed Dr. Tameah back to the floor to deliver the news to Mr. Henry and his family. As we all huddled around the bed--nine family members and five medical providers--the room felt very small.
Dr. Tameah had us each introduce ourselves and describe our roles on the healthcare team or our relationship to the patient. Then he explained Mr. Henry's disease, prognosis and available treatment options.
"The bone marrow of a healthy human body is like a beautiful garden with a variety of healthy flowers--roses, tulips and so on," he said. "The cancer is like a weed. It grows too much and too quickly, and it prevents all of the other plants from growing and staying healthy. We recommend using chemotherapy drugs to treat it. These will kill both the weeds and the beautiful flowers, but hopefully they will also allow new seedlings to grow, without any weeds."
Mr. Henry and his family took some time to process this information, asking questions and making suggestions. Ultimately, with their support, he chose to undergo a high-risk treatment regimen.
He began the treatment the very next day, well aware that this could be the end, but hoping for a better outcome.
Now it's a few days later. I've been checking on Mr. Henry and following his response, hoping that he won't develop an infection without the beautiful flowers that are supposed to protect his body.
I feel a unique connection to Mr. Henry, both as a patient and as a person. For me, our moments together have felt like the culmination of a lifetime of experiences and relationships. I felt privileged to hold his hand during his biopsy, and as I've gotten to know his family, I've also remembered my own loved ones and felt how lucky I am to have people who care for me. Paradoxically, and poignantly, this time of greatest anguish for Mr. Henry and his family has been one of my greatest learning experiences, and I feel so fortunate to be part of his healthcare team.
Now, hearing the music from his room, I have to see this moment for myself. I drop everything and go.
The door is wide open, and I peek in. His two daughters sit next to the bed, strumming guitars and singing. The rest of his family members are circled around, singing and playing along on the tambourine and maracas.
I must have poked my head in too far, because all at once everyone looks at me. They're still singing, but now I feel as if I'm in the spotlight.
They think I might be bringing news about Mr. Henry's labs, I realize. If I don't do something, they'll stop and expect me to say something.
There's only one thing to do.
I start bobbing my head. Then I begin to sway a bit, and even dance.
I guess I look a little silly, because they all laugh.
So do I.
And I keep right on dancing, my stethoscope flailing around my neck, as some of them join me--and together we enjoy this moment of sorrow transformed into bliss.
About the author:
D. Micah Milgraum is finishing his third year at Drexel University College of Medicine in Philadelphia. His professional interests include compassionate care for children and adults with developmental disabilities, diseases of the skin with a focus on melanoma, and medical ethics. When not on the hospital floors, Micah can be found studying (obviously), swimming, painting or playing tennis. He is supported in his endeavors by his loving parents, six older siblings and army of nieces and nephews. "I started writing in medical school because it helped me digest the fast-paced world we live in. I write stories to reflect on my experiences and to develop into a better physician and person. I was encouraged to become a reader of, and now a contributor to, Pulse by my medical ethics professor at Drexel University, Steven Rosenzweig. I am thankful for his continued guidance."