The Procedure

David Mathew1

doi: http://dx.doi.org/10.5195/ijms.2014.74

Volume 2, Number 1: 28-28
Received 05 10 2013: Accepted 31 12 2013

He was an elderly gentleman who presented to the hospital because of dysphagia and marked weight loss.

Numerous investigations revealed no answers; there was no explanation for his symptoms. And now it was time for me to perform a lumbar puncture on him following a suspicion of an autoimmune process, one that the cerebrospinal fluid (CSF)-fluid in his back - could possibly provide answers for.

I approached his bed and he slowly turned to greet me.

“Hi, I’m part of the team, and it looks like we need to do a few more tests to find out what's wrong.”

He grimaced at the word “tests”. It could not be good news having more tests. But he remained strong and gave me a nod-almost robotic in nature.

“I’ll need to do a little injection in your back and take some of the fluid out.”

Ordinarily, a needle in the back would terrify someone - but not this gentleman.

He’d had days of consecutive blood tests. His veins were running out, and the number of attempts required to draw blood increased by the day as the size of his vessels shrunk.

“Go on and explain.”

It took me a few minutes to comprehend the above line he uttered, due to his severe dysarthria. Only after asking him to write it down did I understand.

And whilst explaining the procedure, I watched his eyes brim with tears - tears that equilibrated so that they just filled his eyes, tears that were never enough to trickle down the creases of his weary cheeks. I enunciated each word, explaining the indications and risks. It was as if each word was a dagger, slicing apart any sinew of confidence left in him.

That day I learned to be strong in the face of hopelessness. That day I learned the power of medicine, a power to break even the sturdiest souls. That day I stared futility in the eye.

Patients are subject to the mercy of medical professionals, ones who would usually unleash a battery of tests to find a cure. Yet sometimes we forget the pain that they have to go through, the agony of being subjected to tests to rid their own bodies of destruction. And the simple solution of time – just spending a little more time with patients – may sometimes be the only solution to allay their fears.



Conflict of Interest Statement & Funding

The authors have no funding, financial relationships or conflicts of interest to disclose.

Cite as: Mathew D. The Procedure. Int J Med Students. 2014;2(1):28.

Copyright © 2014 David Mathew

International Journal of Medical Students, VOLUME 2, NUMBER 1, February 2014