Bearing Witness to Pain

 From the January 27, 2023 issue of the Transformational Times

MedMoth Story

 

Bearing Witness to Pain 

 

 

By Meghan Schilthuis 

 

 

Meghan Schilthuis, a third-year medical student at MCW-Milwaukee, shares an impactful patient encounter from her first clinical rotation. This story was shared as part of the 2022 MCW MedMoth storytelling evening…  

 

I began my M3 year this past June on my pediatrics rotation, excited to convert knowledge gained from many hours spent studying for the USMLE Step 1 into “the real world” of patient care. I spent my first two weeks in outpatient clinics and had a lot of fun interacting with relatively healthy kids. I wasn’t sure what to expect as I moved to the inpatient portion of the rotation and began a week of night float at the Children’s Hospital of Wisconsin.  

 On my second or third night, my intern and I got a call about an adolescent boy who would be coming up to our team. I began looking through his chart and learned that this boy, who I’ll call Zack, was being admitted with concern for infection in the context of extensive burns suffered a few months prior. My heart fell when I read that these burns were the result of an attempt to end his own life. What sort of situation would we be walking in to?  

When Zack arrived on the floor, my resident and I went to go see him together. We found him lying in bed, heavily bandaged, and clearly in a lot of pain. After we gathered some history and did as much of a physical assessment as possible, Zack’s mom looked at my resident and asked, “Could we speak out in the hall for a couple of minutes?” I wasn’t sure if I was supposed to follow my resident out into the hall, but felt like I should stay behind with Zack. 

 As my resident and Zack’s mom walked out, I had a brief moment of panic; what could I do or say that could possibly help him feel any better? I had no medication to offer him. His skin was so painful to the touch that I couldn’t offer a hand of comfort. I settled for asking him about the stuffed frog he had. He suddenly stopped writhing, locked eyes with me, and exclaimed, “I wouldn’t have done it if I knew it would be this much pain!” Even though we hadn’t talked about how he got his burns, we both knew exactly what “it” he was referring to.  

I fought back any chance for my eyes to well up with tears. “I’m sorry you’re in so much pain. We’re going to do everything we can to help you feel better.” Even though I knew I probably shouldn’t, I couldn’t help but think of my little brother who is the same age as Zack; my little brother who loves to play football and baseball, concoct interesting culinary combinations, and learn new songs on his bass guitar. How could a middle schooler like Zack be saddled with so much pain at such a young age? 

After a few minutes, Zack’s mom came back with my resident and said to me, “I’m sorry, Zack can be a little dramatic.”

“Oh, no, don’t worry,” I told her as I waved goodbye. My resident and I left to staff the case with the attending before our next admission. 

The busyness of the rest of the shift kept me occupied, but I found myself thinking about Zack as I drove home and got ready for bed. When I called my mom to catch up the next day, I shared some of the story with her. She could tell that I was still feeling badly about Zack. She encouraged me to stop worrying about him, which sounded a little harsh to me at first, but she was correct in pointing out that my concern would not change things for Zack. 

Even still, I left our conversation wondering how physicians can best bear witness to their patients’ suffering without allowing it to consume their thoughts. 

In my interaction with Zack, I felt a tension between my strong desire to alleviate his pain and an uncertainty about how to do that. Even though I felt like there was little I could do for him at the time, looking back, I hope that our brief connection helped him feel less alone in that moment. 

I never saw Zack again after that night and don’t know what happened. Wherever he is today, I hope he’s healing and doing well.  

 

Meghan Schilthuis is a third-year medical student at MCW-Milwaukee. She is one of the student leaders of MCW’s MedMoth storytelling event.