Imagine you are standing in a room. A very small windowless room that, despite the plush sofa and painting of a flower, is a far cry from a comfortable room because comfort
implies pleasantness and relaxation. The room you are in is tense, tight and torrid. You stand as close to the wall as you can, moulding your body into the corner where you can
take up the least space. You are acutely aware of your physical presence because everybody in the room has a role and a reason to be there while you do not.
The patient, in his wheelchair, and his wife, perched on the edge of the sofa, are in the centre of the room and are flanked either side by the Consultant and the Registrar. A look of resignation and acceptance is on the patient’s face. A weary, worn-out diary sits open on his wife’s lap and she begins to read from it questions about medications and
doses, recent tests and further treatment for her husband. It is as though the diary is her compass, to navigate the unforgiving waters of her husband’s journey. It is her map, to ensure that she does not lose her way in the pursuit of a cure for him. It is her weapon, to yield control over the cancer and command it into submission. Her tenacity to fight for her
husband’s future has left her blind to the truth of the present. The battle is over, the ship is lost and her husband is going to die at the age of thirty-four. At the end of the conversation, she closes the diary. The message has been received.
There are numerous times throughout life where you may feel purposeless but throughout medical school, this feeling is a daily phenomenon. We sit in outpatient clinics or stand around bedsides on wards and we observe, we listen and we learn. But we do not help the patient, offer support or actively participate in their care. There are occasionally times throughout life where you may feel voiceless and unable to speak either because you cannot or the situation does not allow it, but throughout medical school this occurs
frequently. Too often a Consultant will not expend the effort to learn our names and therefore we are rarely introduced to each patient we meet unless we take this upon
ourselves. This does not foster an environment where a student would feel welcome to contribute or comfortable with doing so. We are left voiceless. However, there are seldom times when even a facial expression is not possible and throughout medical school, a student could always give a smile in greeting, a sympathising nod when a patient imparts their family history or a wincing grimace as they describe their pain. COVID-19 has taken away the only thing we can consistently offer every patient we meet because it has propagated the incessant need for face masks. In the small windowless room, I am rendered expressionless. Because of a sheer humanistic need to convey my condolences with the patient and his wife and because I am reduced to a pair of eyes, tears began to cloud my sight and a lump lodges itself firmly in my throat. I will the droplets to stay put but they do not listen and instead spill onto my cheeks and into my mask. I step out of the room to regain my composure. Soon my overwhelming frustration at being extraneous and expressionless is dwarfed by the realisation that any feeling of helplessness I have felt, the patient and his wife have just experienced a hundred times greater. Their surrender to powerlessness and vulnerability is permanent. I can take off the mask to regain what COVID-19 took from me but they can never reopen the diary to regain what cancer has taken from them.
