Home Journal Issues Journal Index Blog Search Contact Us Help

Volume 2, Issue 1
Spring 2006:


Sara G. Goldman

Cell 2 Soul. 2006 Spring; 2(1):a18

"It's hard," she says, "so hard," and her thin fragile fingers twist nervously in her lap as she stares out the window, struggling to control the tears that fight to escape.

"I've forgotten what normal is," he states, leaning forward in his chair as if to emphasize his words with his bulk. "I don't know if I feel depressed or not; I just don't feel anything anymore."

"I'm real scared," she says softly, suddenly looking directly into my eyes, then lowering her gaze just as quickly. "I know I'm not going to get better."

Their voices echo in my head as I finish writing my notes in the fading light, preferring the twilight's blur to the click of a switch and the sudden harsh glare. This one received a prescription, that one will return next week, all have been offered empathy and hope. But as I close my folders, my head drops on my arms and my pen falls to the floor as their uncried pain flows from my eyes. The darkness of their depression, filling my office hour after hour, evokes my own skyless eternity of despair, and I shudder to remember the deception I'd been practicing all day. What would they think if they knew that as we'd been walking side by side, hour by hour, patient by patient, that as I'd been steadying each to fight against their pain, I'd been struggling not to be broken by the depths of my own despair? Getting up to pace, I gaze out the window as the twilight deepens into night, and see my image reflected in the now-darkened glass, hovering above the chair occupied all day by the owners of the voices that haunt me yet; quickly I move back to my own desk.

My thoughts are interrupted by a timid knock on the door, and the medical student enters. "Excuse me," she begins, "but I couldn't stop thinking about that patient we saw together last night on call. I went back to talk with him again today, and I still don't understand. He's a bright, educated man, with a caring family and so much to live for. Why does he want so badly to die?" Puzzled, she gazes at me and I am struck by how out of keeping her troubled eyes are with the youth of the rest of her face. My mind flashes involuntarily back to an image of myself in medical school, in a fresh short white coat, when illness was a new terrain to study and all was yet possible; quickly I wrench myself to the present. "It's a symptom of his illness," I reply, "and when his depression lifts, those thoughts will fade. Meanwhile, we need to keep him safe." "That's all we can do for him while we wait for his medication to kick in?" she asks, disappointed. I lean forward in my chair to underscore my words and reply, "The most important thing we can do now is to maintain hope, for right now, he has none. Don't underestimate the importance of just forming a human connection with him, so he does not feel alone." My fingers twist in my lap as I add softly, "Unless you've been there, the patient's world is the hardest thing in medicine to understand. But with honest concern and kindness, it is sometimes possible to catch a glimpse of the suffering, and in doing to, to help ease the burden of pain." She exits and my eyes drop, suddenly exhausted by her youth and innocence.

As I pull on my coat in the darkness of my office, I hear yet again the thoughts of my patients filling the room: "Am I going to make it? Why me? Help me, I can't go on like this." Frightened, I quickly flip the light switch on, then off again, then pull the door shut behind me while fumbling in my pocket for my car keys. But before the door thuds locked, I glimpse my reflection in the window once more, this time standing hopelessly between my desk and my patients' chair, and my vision blurs as I fight to keep from stumbling in the darkness of the deserted, echoing corridor.

Return To Top