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Her Story of Present Illness

Prescott, Jessica Elaine

doi: 10.1097/ACM.0000000000001592
Teaching and Learning Moments
AM Rounds Blog Post

J.E. Prescott is a second-year medical student, Keck School of Medicine of USC, Los Angeles, California; e-mail: jessica.prescott@med.usc.edu; Twitter: @J_Prescott25.

Author’s Note: The name and identifying information in this essay have been changed to protect the identity of the individuals described.

An Academic Medicine Podcast episode featuring this article is available through iTunes.

She was my very first patient. As I stood outside her door, I nervously adjusted the collar of my short, blindingly white coat—a constant reminder of my status as a brand new medical student. I slowly exhaled, knocked, and entered her room.

Mrs. G was the same age as my mother, and her olive eyes were rimmed with the dark circles of someone who had not been sleeping much. From a scroll through her chart earlier, I had learned that the daughters sitting next to her were born the same amount of time apart as my sister and I were—four years and four months. My eyes drifted, processing the similarities, until an alarm bell sounded across the ward, serving as a swift reminder of exactly where we were.

Returning to my clipboard, I began the only clinical duty I could independently perform as a medical student. I asked for her story.

Working together, we began to unravel her diagnosis of Stage III ovarian cancer, the symptoms she was too busy to investigate earlier, the swift upending of a stable family dynamic, the forced time away from her productive and fulfilling career. She gave a meticulous description of her treatment plan, incorporating her surgeries and chemotherapy regimens into a coherent narrative.

Although this woman was very much aware of her condition, I sensed she was not the main character of her story. For every detail she gave about her cancer, she gave two more about how her cancer impacted others in her life. She cringed as she told me about the project she had to leave behind at work. I learned more about her fear that one of her daughters would experience a similar diagnosis in the future than I did about her own concerns moving forward.

Since that meeting many months ago, I’ve noticed this pattern not only in other patients but also in my own family, with my female friends, and with myself. Women have traditionally been the primary caretakers in their families and communities, prioritizing others’ needs far above their own. While the saying goes that doctors make the worst patients, I’m now convinced that physicians are only a small segment of those who provide care but have difficulty accepting it.

Women in medicine are doubly affected, but we are also in a unique place to lead by example. Just like our patients, without our health, we cannot appreciate all that we’ve worked so hard to achieve. For me, that means periodically trading in my white coat for a patient’s gown. It means protecting time outside of school—and someday work—for runs, walks, and quiet reflection. Most importantly, it means accepting help when I need it and encouraging my patients to do the same. Since that day with Mrs. G, I’ve realized that caregivers who invest in themselves should not feel selfish or weak. They should know that their wellness is critical to their ability to help others achieve their own wellness.

To be a woman’s physician is to know her story and to remind her that she is the protagonist of her own narrative. As a doctor, I hope to have the privilege of hearing some of the most meaningful stories of women’s lives. Maybe, if I’m lucky, I’ll be written into them.

Jessica Elaine Prescott

© 2017 by the Association of American Medical Colleges