Four years ago, I began learning the art of healing with the start of medical school at the Technion in Haifa. In two weeks, I will recite the Hippocratic Oath and the Oath of the Rambam and will be conferred the degree of Doctor of Medicine. Whoa.
Below, I chose to detail one encounter out of many in an attempt to summarize my past four years. For the sake of confidentiality, the patient story is based on reality, but fictionalized.
During my internal medicine clerkship, I saw a poorly compliant 21-year-old Russian immigrant with type I Diabetes Mellitus, and had the eye-opening experience of discussing with her the potentially severe complications of her disease. Because her Diabetes was dangerously out of control, she had multiple hospitalizations for disease complications. At the time of our conversation, it seemed clear to me: take the medication and keep the diabetes in check. The alternative of potentially going blind or needing leg amputations in the future seemed so severe and imminent that it was hard for me to fully appreciate her reasons for non-compliance.
Later in the year as part of a training session, I wore an insulin pump for three days. Don’t worry—the pump was injecting normal saline, not insulin. Over the course of those three days, I meticulously counted my carbs, tested my blood glucose levels via needle prick, and before every meal, I inputted into the machine the amount of fake insulin to inject. I slept with the pump and woke up in the middle of the night when I accidentally set off the internal alarm. It was a valuable experience that allowed me to better appreciate the practical realities of wearing such a device. Thus with time, I gained a better understanding of why my 21-year-old patient with type I Diabetes might have disconnected her pump so frequently.
My time as a student is quickly ending and I am about to embark on an exciting and challenging journey as resident. In a few short weeks, I will be moving from Jerusalem to Manhattan to start a shomer Shabbat residency position in the Bronx at St Barnabas Hospital. It is a bittersweet move—I am so sad to leave my family and friends in Israel but am very excited about the new stage ahead. If you have any tips for how to survive intern year or how to acclimate to New York, please advise.
We should be blessed to continuously have a curiosity for learning and deep compassion for our patients, family, friends and colleagues.
Warmly,
Rebecca Neril (2014)