I Learned About Medicine From That

The Heart of our Calling. A Sensible Medicine Guest Post.

A year after I was born, my brother and I were diagnosed with a rare, non-progressive form of retinal dystrophy. Like many parents, mine moved to the U.S. to seek a better life for their children. In our case, our parents were also seeking a cure. There was none. As a kid, I met a low-vision specialist, Dr. P, who shared this reality with gentle honesty. But he also encouraged me to pursue my dreams and promised to help me find my way. In many respects, he exemplified the qualities every patient wants in their doctor: dedication, candor, clinical acumen, and fierce empathy. My parents raised me to recognize my limitations but to have confidence in my talents and work ethic. With this perspective and support, I built a meaningful life of independence, from getting a driver’s license to becoming a physician.

Medical training, as it turned out, would routinely remind me of features that had already defined my life - trust in the face of medical limitations. I would see this in my own patient’s stories.

As a sub-intern in medical school, I cared for Mr. S, a gentleman in his fifties with high grade neuroendocrine carcinoma. He had been admitted with multi-organ failure. Multiple lines of treatment had given him precious time with his family, but when I met him, his cancer had exhausted our therapeutic arsenal. Our attempts to discuss palliative measures were met with resistance. Mr. S was not ready to die. A few days after I had met him, Mr. S’s primary oncologist took over the service. He sat down with the patient and delivered the prognosis candidly but gently. At the end of that conversation, before Mr. S transitioned to comfort care, he told his oncologist “I trust you, doc.”

In that interaction, I saw a bond forged through the triumphs of hard-fought remissions and tragedies of devastating relapses. As a resident, I have taken care of patients like Mr. S and seen again how trust can endure in the face of vulnerability. One such patient, Mr. H, had metastatic non-small cell lung cancer. I met him as an intern, and months later, he returned to my care when he was admitted with a large pulmonary embolism. “Sorry you’re back in the hospital, sir,” I said. He replied, “So am I, but I am glad you are my doctor again.”

I learned about medicine from that. Illness and suffering can be viewed through many lenses. As an aspiring oncologist, I focus on the promise of novel therapies to prolong survival and improve quality of life. This lens is essential, core to our mission. And for this reason, Mr. H’s compliment felt unearned - we had made little progress against his cancer. Yet, it also reminded me of how Dr. P earned my trust even though he could not restore my vision. Undoubtedly, our circumstances were starkly different, but our stories revealed an essential truth. Even when we cannot cure our patients - perhaps especially when we cannot - we must earn their trust as confidants and advocates, the heart of our calling as physicians.

Aiman J. Faruqi is a resident in Internal Medicine at The Mayo Clinic.

Photo Credit: Lauren Lulu Taylor