Under the Layers
Panacea Writing Contest: 2nd Place Winner
The following piece, written by Mariam Dogar, was selected for 2nd place in the 2nd Panacea Writing Contest.
First, she whispered “I’m okay” slowly. Then, once the words had adjusted to their weight in the air, she was able to speak them again. Louder and surer of herself, she repeated, “I’m okay. I’m ready.”
Bella was an 11-year-old who just started chemotherapy for leukemia. She had been in the hospital for the past 3 weeks with a series of “one thing after another.” A cough and fever had turned into a full-body infection, and now the space around her right lung was being drained by a tube. My resident and I had one job that day- remove this tube - and Bella, though frightened and tired, was very much on the same page.
My resident and I peeled back the rainbow crochet blanket followed by the cheetah print fuzzy blanket that had been warming up her tiny, cold frame. My resident asked Bella, “When we pull the tube out, I want you to hum a nice long note and don’t stop until I say so. Should we practice?”
Bella nodded and started to hum. As she hummed, the sound of her voice made her start to smile. “Can we all hum together? And can I hold my mom’s hand? That always makes the times they poke me better.”
We proceeded to hum and pull the chest tube. As it came out, Bella’s hum became more of a high-pitched yelp and her eyes began to water. “That really hurt,” she said afterwards. “I’m okay though. Thank you.” And then she started to cry.
Her mom gave her a big hug and started to get teary-eyed too. “Bella, baby, it’s okay to cry. We don’t expect you to be okay.”
We stayed for another few minutes consoling Bella, by the time we left her room, we each had a generously gifted K-pop sticker and a smile. However, the range of emotions and feelings she expressed have stuck with me throughout my year rotating in the hospital. I’ve since seen the same struggle between fear and hope, undulating waves of both uncertainty and perseverance, weighing on my patients and patients’ families of all ages, just expressed in different ways. However, I frequently come back to the actions of an incredibly mature 11-year-old and her overwhelming desire to be strong despite the cards she had been dealt.
So many patient-provider interactions broach topics that are uncomfortable. Some days it can feel like you’re delivering a string of bad news or causing pain all day long without having the space to deal with the aftermath. But mornings like the one spent in Bella’s room truly remind me of why I went into medicine in the first place. It wasn’t just to make others feel good. Some days, you must sit in the bad and the unfair, and patients just need you to be in solidarity with them - especially when they have no one else. I think that is one of the most important privileges a physician has.
About the Author: Mariam Dogar is a third-year student at Harvard Medical School. She previously was a biology and urban studies student at MIT. She currently is an editor of her medical school’s humanities magazine, In Vivo, and is also an author of a poetry book called Our Ancestors Did Not Breathe This Air.