The first one who didn’t cry

By Chaya Murali, MS4

Right now, I’m on a dermatology rotation. What this translates to is checking lots of elderly men for the telltale bumps and scales of early skin cancer. This is why I was surprised last week when the patient before me was a fit middle-aged man. He was here concerned about a few moles, he told me, because he’d had a lot of siblings diagnosed with local melanoma.

I took a look at the many spots he pointed out. During my exam, I was struck by just how nervous he seemed: sweat ran down from his underarms, he drummed his fingers on every available surface, and generally radiated an aura of anxiety that seemed disproportionate for a doctor’s visit, even one that was screening for cancer. Only one of his spots ended up earning a biopsy, and I set about completing paperwork and setting up the supplies for the procedure.

As silence settled within the room, I told my patient he could answer his text messages if he needed to—his phone had been buzzing constantly throughout our visit.

“I’m sorry,” he told me, “It’s been a long week—and it’s only Tuesday.” He went on to explain that he was planning funerals for four coworkers and helping countless others handle their difficult emotional reactions.

I was shocked. This was the last thing I’d expected to hear. “What do you do for work?” I asked. He told me he was a firefighter.

And then it all made sense. This man had fought the fire that had been all over the news. Four of his colleagues had died. One of them had graduated from my high school. I told him this last fact, and he began to open up. My patient told me about the coworkers he was worried about, the terror of fighting that fire, the pain of losing those brave young people.

In the last 17 years, he told me, the Houston Fire Department had lost 8 firefighters in the line of duty. That fire just a few days ago had claimed four.

“I’m sorry to be bleeding on you like this,” he kept saying as he talked about the fallout from the fire. Again and again, I told him not to apologize. One of the great pleasures of being a medical student is our gift of time—with fewer demands than residents and attending, we have the luxury of spending ample time with our patients. I told him that just because I wasn’t on a psychiatry rotation didn’t mean I couldn’t try to help by listening to him talk.

And talk he did. I was glad to listen, inserting sympathetic statements where appropriate, but I could tell this man simply needed a listening ear.

Once the biopsy was over and done, I wished my patient the very best. I told him he should look after himself while caring for his colleagues, and that I had been glad to listen to him. “You know,” he told me before he left, “You’re the first person I’ve talked to about this who didn’t break down crying on me. Thank you for that.” I told him it was my pleasure, thanked him for his service, and watched him walk out of the clinic.

He didn’t know this, but I did break down later. Every once in a while, we forget that the patients we treat are human beings in the world just like us, that they lose loved ones and care deeply about their jobs and do their best every single day. This patient reminded me of that, just when I needed reminding. I’m honored to have participated in his care, and I hope I helped him—and not just with that biopsy.