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Dear Joanna

By Uju Momah

Dear Joanna,

When we met during my surgery clerkship, I anxiously walked into your room. It was my first morning rounding on the floor, and I was nervous—like any medical student—about all the little things to come: Where were the gloves? How would I properly scrub in to the operating room? How could I be most helpful to the medical team? What questions would I get “pimped” on? I was anxious to be in a new environment and desperate to acclimate to the hospital's frenetic pace. So, when I walked into your room on my first day, I must have looked out of place. Your eyes met mine, quickly scanning me up and down. You were perceptive, as you saw my short white coat, or perhaps I gave myself away with my pockets spilling of surgical tape, gauze, and cutting shears while the residents and attending were simply clad in scrubs.

Not knowing who I was, you quickly contextualized my role on the team. As my attending started, you turned your attention to her, earnestly hoping for good news. Knowing your labs and what was documented in Epic, I anticipated what was coming—another morning of learning that you would not be discharged. And when my attending confirmed my suspicions, your abrupt slump in posture and glazed eyes conveyed your disappointment. It was understandable: You were a teenager in your second week of hospitalization after surgery.

After a morning of cases, I returned to your room and properly introduced myself. After getting approval to examine you, I approached you with a stethoscope, prepared to listen to your lungs. Reluctantly, you sat up and allowed me to proceed. After listening, I attempted to engage you in conversation, asking about your day. You were initially reserved; your answers were short, and you seemed unreceptive. Your unfriendly manner could easily have been mistaken for indifference, an oversight I originally made. Over time, however, when I returned to your room for rounds and bed checks, this changed.

As you grew more trusting, I quickly learned about your family and dream of becoming an engineer. In this context, I was reminded that you were not only a patient but also someone's daughter, sister, and friend with goals and ambitions. And once you grew even more comfortable with me, I ultimately learned why you were so upset during our first encounter.

For months, you grappled with symptoms of fever and fatigue that were previously discredited by well-intentioned providers. On top of these frustrations, you also struggled with taking time off work even to see your local provider. So, when you did see them and your concerns were dismissed, you felt that your efforts were futile. The amalgamation of these experiences contributed to your distrust of the health care system and heightened your anxieties.

Months later, you developed leukemia and recently acquired a nosocomial infection requiring lung resection. However, all you wanted was to get better so you could return home. When I learned of your challenges, I understood your frustrations. Hearing your experience brought urgency to grasping the deeper dimensions of you beyond my initial first impressions. I quickly realized that you were more complex than I originally appreciated: What I mistook for passiveness was actually quiet strength. Yet, beyond this, I learned why you trusted me—you felt willingly vulnerable and validated during our time together.

Knowing how much you enjoyed our conversations, I made it a point to stop by your room because I wanted you to feel safe. Our debates about our favorite sports teams and musicians provided you with a haven to temporarily forget about your disease. Forging such a relationship was important because it allowed you to feel unashamed and unapologetic about your circumstances. In these moments, I was repeatedly confronted with the notion that, as a future physician, my role would be to help patients achieve good health and ensure that they feel “heard.”

Looking back, when I first started my surgery rotation I was nervous about things that now seem inconsequential. Now when I return to the hospital, I am reminded of our early encounters, ripe with honesty, strength, and resilience. When we met, I had the intention of helping you; little did I know that you would be helping me—helping me tangibly appreciate what it means for patients to feel “seen” by their doctor and validated in their concerns.

Thank you for allowing me to be in the room that first day. Thank you for your vulnerability every day afterward. Our time together holds an indelible place in my memory. When I am reminded of it, I feel reinvigorated to become a doctor. The lessons that I learned from you inspire the type of physician I will be: grounded in sound clinical judgment and guided by the experiential insights of patients. As a doctor, I aspire to walk the path with patients I serve and better understand the depths of the human condition.

In retrospect, my connection to you is one of my greatest motivators. I am convinced that, as a future physician, it is incumbent upon me to foster humanism in medicine through both clinical practice and narrative medicine. I see medicine as not an isolated career but a field very fluid with the art of storytelling—and, when properly integrated, capable of enhancing the well-being of entire populations by changing how physicians approach patient care. It is important to reflect on such stories as yours and share them with others because, when authentically done, storytelling changes how we think. I strive to better understand patients, and I hope to electrify these sentiments in others through narrative medicine.

In closing, to paraphrase the Dalai Lama, when talking, you share knowledge. However, when listening, you venture into someone else's consciousness and learn something new. As a future physician, I am eager to meet patients, traverse their difficult journeys with them, and share their perspectives with others through narrative medicine. In discovering this passion, I owe my deepest gratitude to you.

Sincerely,

Uju

Uju Momah
University of Connecticut School of Medicine
Graduating Class of 2021

Back to the November 2021 issue of ACP IMpact