Thread by @TheRealDoctorT

“I closed my mouth and spoke to you in a hundred silent ways.”

-Rumi.

Boston is a beautiful city, particularly in the Fall.

The way the colors reflect in the Charles River. The way the ivy grows and clings to the old buildings.

It is a city with many stories to tell. 1/

Unfortunately, they’re stories I can’t hear. And the beauty is lost on me, for I have no time to appreciate it.

I am an intern, and I could be in Heaven itself and not notice anything, except how many tasks I still have to get done.

My life is a to-do list that only grows. 2/

The hospital I’m training at is in the heart of Chinatown, in Downtown Boston.

On this particular day, I have been savagely busy. I am on the General Medicine team. We are the engine that drives the bulk of the admissions and discharges from the hospital.

It is a grind. 3/

I don’t know what I thought medicine would be, but it wasn’t this. I thought I’d have more time... somehow.

There’s never enough time.

I round on an elderly patient. She is Chinese, Cantonese-speaking only. Her room is filled with family members. They translate. 4/

After I examine her, then explain the plan for the day, everyone nods along. They have no questions for me.

I leave the room, order the tests and meds, and move on.

About 10-15 minutes later, the patient’s eldest son emerges from the room. He wants to speak to me. 5/

It turns out they disagree with my course of action. The patient wants to pursue a more conservative course.

I feel a surge of anger. Really?!

I just spent a significant chunk of time explaining everything. I asked them if they had questions. Now I have to cancel it all? 6/

The senior resident on my team back then is someone I still look up to and respect, to this day.

He senses my anger, and calmly intercedes. “No problem at all, that sounds like an excellent plan.”

He then takes me aside, into a separate meeting room.

“What’s up, Sayed?” 7/

I explain, this isn’t the first time it’s happened. I round, and then they want to change the plan 15 minutes later.

I’m an intern. I know nothing. I’m a meaningless MD, nobody cares what I think. And now the patients are disrespecting me.

He raises a brow. “Really...” 8/

I feel childish for my outburst. I know it’s not really true. I think my resident knows it isn’t true either.

But, like all great teachers, he seizes a teachable moment in my frustration to show me a truth.

“You think they’re disrespecting you by changing the plan, Sayed?” 9/

“You’ve got it backwards. They’re doing this BECAUSE they respect you so much. You’re their doctor. They will never disagree with you in front of all their family. Whatever you recommend, they’ll agree, to save you embarrassment.”

He smiles.

I feel a lump in my throat. 10/

“I know it’s difficult being an intern, but it’s nothing compared to being a patient. Go easy on them, appreciate their culture. Round, but don’t enter orders right away. Give them 10-15 minutes to talk it over. No biggie.”

I feel ashamed, and nod. “No biggie.” 11/

As I leave the meeting room my eyes have been opened.

The next time I round on that patient, I notice how much I missed before. How many gestures are unspoken.

The way they all stand when I enter. The smile and slight nod of the head the eldest son gives me.

I am humbled. 12/

It was never my role to tell them what to do. The choice was always theirs. That I couldn’t see what they were doing for me wasn’t their fault.

I am deliberately more sensitive, after that.

One of the many beautiful things about medicine is how it brings people together. 13/

My residency has people from all over the world and all walks of life. When we are working together, caring for patients, none of that matters.

We all walked different paths to get here, but we are here now.

All that matters is what we can achieve, together. 14/

Boston is a beautiful city, particularly in the Fall.

The way the colors reflect in the Charles River. The way the ivy grows and clings to the old buildings.

It is a city with many stories to tell.

As intern year comes to an end, I am finally listening.