Old face, new tears — Chronicles of a Medical Student

25th of March 2021

Nearing the end of my geriatric rotation now, the very last block of the hospital stage of my third year in medical school. I only have a handful of placements left and seeing patient after patient the days become a blur, a conglomerate of faces and common disorders.

I confront every single patient with the same level of respect and utmost consideration of them as an individual, but after countless individuals memories start to fuse and morph into the "quintessential patient" of that specific specialty, something that I believe is unavoidable.

From speaking to my peers, I have realised this is something not restricted to my experience jumping onto the clinical stage for the very first time. However, there are occasions, patients, that unbeknown to you prior to the interaction will raise above the trend and stay with you.

One such interaction occurred a couple of days ago.

My clinical partner and I busied ourselves with the donning of PPE after reading the notes and familiarised ourselves with the case. After 6 months of placement you settle into the routine and revel in it, glad to know exactly what you are doing.

We confirmed that this elderly man in his eighties was indeed the right patient, explanation was given, consent obtained and curtains drawn.

As we were in the stroke ward we centred our line of questioning around sudden focal neurological deficits with symptoms of unilaterality and timing of events, perfectly running through a semi-fixed protocol that has formed in my mind.

Once the presenting complaint and history of presenting complaints were fully characterised, we moved onto past medical history, drug history and family history to obtain a clear picture.

Among other things, he elaborated on how in the late 50s his mother had sadly passed away when he was barely a teenager and how tragic it had been for the family.

I was utterly unprepared when he stopped speaking a minute or so after that, his halfway stoic and amicable expression breaking down. His piercing blue eyes became glassy and his face lined by the wrinkles of time distorted into a picture of sadness.

"I'm sorry, it's me mum..." I remember him saying, apologising, tears streaking down his face. I offered him some tissues, reassured him it was absolute fine and waited patiently.

Nearly 7 decades had passed since the tragic death of his mother and yet, in the face of suffering a stroke and being hospitalised in the middle of a pandemic where largely being old and going into hospital was synonym of death sentence, these thoughts resurfaced.

It taught me an extremely important lesson.

Yes, time cures all emotional ailments, or at least helps greatly in the mending of those mental injuries. But, unlike physical scars, emotional ones are not fixed forever and circumstances in your life might reopen them when you least expect it, and after seventy years of having your mother unjustly robbed from life, you may still cry.