Storm

Eager to be doctors and learn how doctors work, six medical students stayed with me when I was on call this Thursday. In fact, once upon a time, I was just as excited to follow the doctors when I was at their age, maybe even more so. And slowly the idea or know-how of doctoring percolated into my mind.

Young minds tend to be the most sensitive. I wished I could give them a better sense of how to be a doctor. At the same time, I was furiously trying to keep my patients alive. We saw patients together. One of my patients got chest pain. An old lady. Her heart beat in a mad, higgledy-piggledy rhythm. I saw great chance to teach my students every inch of complete heart block.

After taking out my stethoscope, I was amazed to find a loud heart sound like a thunderstorm. Thump, thump, thump. In the same way a rusty and broken door makes a squeaky sound, the patient's heart valve was leaking to make that loudest, scariest, queasiest possible noise. "This murmur wasn't mentioned at all when the two doctors examined our patient this morning," I cautioned. That's something new.

I faked equanimity, which is my strong suit, and pointed out the story of sudden breakdown of heart valve's scaffold support. Implicit in this condition is the no-fun-at-all standstill of heart's horsepower. The thing is, I wasn't sure the elderly lady could survive without surgery, which she can't tolerate either.

I didn't, and couldn't, teach my students to repair the ruptured heart valve. "We as doctors have the illusion that we can fix everything, but we can't." I ended up teaching them how and when to tell our patients (or their family) it's a thunderstorm beyond our capability to fix.