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“Who are you?” At 20 years old, I stood face to face with my abuela, but I was now a stranger. Our relationship had been erased with those three simple words. My abuela, as I had known her, was gone. I had been fighting this reality for the past few months, but was now assured there was no chance to reverse the effects of her dementia. In the following weeks, I read medical research looking for evidence of treatments that would heal her. I found only literature suggesting ways to slow her progression. Fearing that any one of my family members could be the next victim, I did what I could to educate them on the importance of diet and exercise. I often escorted my abuela to her doctor’s appointments and ironically found comfort and support in the same office where we had learned of her diagnosis. The compassionate demeanor of her physician was inspiring. Through knowledge and education, she was able to provide momentary respite when the inevitability of losing a loved one was drawing near. I was confronted by this unique juxtaposition of grief and inspiration which drove me to explore medicine and the physician’s role when treatment and prevention have failed.

This newfound notion of compassionate care led me into my next semester at [name of school]. Fortunately, I had the opportunity to work with the underserved populations in [name of city] through the [name of clinic]. The clinic’s mission was to improve both functionality and self-sufficiency through rehabilitation. I was paired with a 32-year-old female named Patti who suffered from cerebral palsy and cystic fibrosis, a debilitating marriage that left her confined to a wheelchair. Upon meeting Patti, I noticed she avoided eye contact and presented with a general malaise that seemed to weigh on her. Initially, our training sessions were templated and we were encouraged to follow a regimen that worked for the majority of patients. This proved ineffective for Patti. She rarely smiled and reluctantly transitioned from one exercise to the next. Our training had only begun, but quickly stagnated. I sought permission to implement my own techniques and drew on my past coaching experience with youth soccer players. I educated Patti on the short and long-term benefits of specific exercises which helped her make her own decisions. I hoped letting her determine her treatment plan would evoke a sense of self sufficiency that would in turn enable her to attain a better quality of life. Her mental progression became clear as the “new” Patti was ready to tackle each session. Our sessions showed me that addressing the psychology of the patient can be just as important as the physical. Especially in populations that may be subjected to feelings of helplessness, this aspect is paramount. With a poor psychological disposition, even common procedures and treatments can be rendered ineffective. Ultimately, it would take a professional who is able to understand and leverage the physical and psychological aspects of disease to provide the best outcomes.

With the desire to promote patient advocacy and ease the many manifestations of pain, I sought a position where I could assist in the treatment of disease rather than the rehabilitation. I joined an orthopedic practice, scribing for [name of doctor]. It became clear that many of our patients suffered from chronic conditions that did not have a simple resolution. It was discouraging to realize we were limited in our treatment options and could not offer more. This realization came with the encounter of an 80-year old female with a failed total knee replacement. She had been traumatized from her experience with her primary knee and had been putting off any further treatment. Despite being an hour behind schedule, [name of doctor] sat and listened as both a physician and a confidant. He acknowledged her symptoms, and spoke to her as a person, understanding what she wanted out of her life. I observed the epitome of compassionate care from [name of doctor] and learned that patients are not simply an aggregate of their symptoms. His unique style of listening and communication is able to soothe the emotional burden that may otherwise be suffered alone. This standard of care is one that I aim to emulate and grow upon in my career so I can show my patients that their respective diseases are not their identity. I have learned that the difference between a good physician and a great physician is that the former treats the symptoms while the latter treats the person as a whole.

The appreciation I have for physicians and their profession reminds me of when I felt lost in the shadow of my abuela’s dementia. I was given a healthy outlet to voice my concern and found knowledge governs the unknown. I see that a physician fulfills both the need for authentic communication and the expertise to intervene when the body cannot heal itself. I have built a passion to transfer this same privilege to others. Through compassion, I will embody what it means to treat the patient not the disease.

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