I learned about medicine from that: aboard the La Rabida Children's hospital

In the Spring of 2008, I was stationed aboard the La Rabida Children's hospital. The hospital was perched on a peninsula that jut into Lake Michigan on Chicago's South Side. Outside all the windows spilled tranquil blue water. We could have been in the Pacific.

The patients were a mix of kids who were hospitalized for a treatable conditions, like diabetic keto acidosis, as well as those who were incurable, like a cute 2 year old boy with a brain stem tumor that grew relentlessly after neurosurgery.

I was a third year medical student and assigned there for pediatric rotation. The children were a delight— you couldn't help but smile when you saw their cute faces on rounds, but the moment you reflected on what they were dealing with, the moment you thought of their parents or siblings, you would be crushed. This poor boy was dying of this tumor and there was nothing left.

Then the parents would visit— working people, coming to check on their kids after work. Often, they were black, this was, after all, the South side of Chicago. And often, siblings would join. They would hold the little boy, and kiss his cheek. I would only catch glimpses and then run away, back to the call room, where I would cry silently into the pillow. That's when I knew pediatrics wasn't for me. I couldn't bear witness to this pain.

And yet, with children, even those who are dying, there is always joy. A kid does something cute on rounds or makes a joke, and, we all laugh and smile. Even though we know where the boat is sailing, there are still calm days at sea, and you can forget.

I won't apologize for what I am about to say next: but the residents did not impress me. I suppose that also kept me away from pediatrics. Maybe they were overwhelmed, or under trained, or maybe they too, like me, were crying in the call room, but I felt they were forever mired in minutiae and could scarcely explain the big picture to me. The taught me to calculate fluid rates, but they didn't tell me: why was this boy dying here and not at home? I continue to believe it is a problem we pay doctors so much to replace knees in old, overweight people and pay them so little to care for our children. I think if the pay were different, fields would metamorph.

During my pediatric clerkship, I was dating a nurse I had met in the ICU. She was around my age, 24, infinitely glamorous and approached me one day a few months before and asked for my number. I was completely confused, to place orders? I wondered. But, as a student, I wasn't allowed to place orders. She texted me a few days later, making intentions clear. It remains one of the few times in my life where I was pursued. She was spontaneous and full of energy. I liked her tremendously.

Yet, when I met her after work and on weekends, I didn’t feel myself. I am irreverent, and sarcastic, and always hyper present, but these traits were gone. I found myself distant and humorless. It was the children's hospital. I couldn't shake what I was seeing there. Naturally, within a few weeks we broke up. I wonder if things would have been different had I been on a different rotation.

You couldn't feel sorry for yourself in the children's hospital. A break up was nothing in comparison to what the families were going through. In fact all the obsessions of a medical student— what will I specialize in? Where will I match?— felt petty and small.

I learned about medicine from that. I learned in the La Rabida Children's hospital that there are things far worse than anything, worse than your death. There is visiting your dying baby boy in the hospital after a hard day of work and bringing his older brother and kissing him on the cheek, knowing what was coming. Trying to explain to a sister who might not fully understand.

And then, a decade later, a pandemic would strike. One of the first orders of business was the administrators— those abject pieces of shit— deciding that only one parent could visit a child at a time—that brothers and sisters would have to sit in the car. And it didn't matter if they were willing to test, or supply their own PPE. It didn't matter that the virus targeted the elderly and not kids. The rules were the rules. And later, they weren't allowed in if they didn't get a shot that didn't halt acquisition or transmission, a particular cruel and insipid policy, set by, and again, no apologies for this label, utter pieces of shit.

And that's when I learned that there is something worse than kissing your dying boy, and that is not kissing him, or not having him see his brother because we have to ‘be safe’ because ‘thats just our policy’ or the ‘cdc said so’. Even Dante was not this cruel.

Many of you know that I fought this policy with all my vigor— calling it a human rights violation— and in so far as is possible, I violated it and aided the violators, but my colleagues were mostly silent and complicit. It saddens me to know we, in medicine, lack moral courage and are selfish. And it doesn't surprise me to see the public doesn't trust us and wants us to atone for our sins.

The families aboard the SS La Rabida let me bear witness to unimaginable pain and moments of joy and levity in the spring of 2008. Did I do right by them in the spring of 2020? Did I do my best? And where were my colleagues? How did so many go along with this?

Right now my colleagues are holding meetings to #resist cuts to their grant funding. But in 2020, there were no meetings to resist hospital visitor policies. Perhaps we all need to more time on the SS La Rabida.

https://pubmed.ncbi.nlm.nih.gov/35472383/