Through The Looking Glass: Kleenex and Cheez-Its

by Claire Guo | 10/15/15 7:05pm

10.16.15.Mirror.ClaireGuo_AliceHarrison
Source: Alice Harrison/ The Dartmouth Staff

15F. September. DHMC. I crossed my legs, my laptop precariously balancing on one knee as I frantically scrolled through the form with checkboxes ranging from “depression” to “paying bills.” I had to find the box for “anxiety” before the woman sitting next to me listed another symptom of dementia.

The patient’s voice broke. I stopped scrolling. The resident in charge handed the nearby box of tissues to the woman who seemed far too brilliant for dementia’s strike. She thanked him and took only two, using one to wipe her eyes and tearing the other to pieces. I wanted to take her hand, to do something — anything — to show her that we could do more than just transcribe her speech and analyze her symptoms. But I sat still, waiting for the small room to house more than hiccupped breathing. “Anxiety” had long ago left my mind.

The woman’s glasses fogged with the moisture of her tears — her hands, now in her lap, wrung together, squeezing the old tissues in her palms. I lowered my laptop screen. The resident again offered her Kleenexes. This time, she took the entire box.

I wasn’t sure what to do. Should I look away? Would the patient interpret my shifting of gaze as a sign of discomfort or a sign of respect? Would she even notice? I used my thumb and index finger on one hand to pinch the pressure point on the other and willed my own eyes to please remain dry. I turned my attention to the resident — surely, he’s seen it all. He sat with his elbows on his knees, eyebrows furrowed in empathy, softening his stare. I couldn’t help but wonder if he truly felt for her or if he simply pretended to, already desensitized after months of clinical work.

My heart broke for her. Out of compassion. And pity. And knowledge. She was alone without a husband or kids, fully cognizant of her decline and dementia’s cureless hold. She knew, as did everyone else in that room, that she would only get worse.

Will she die alone? Will she find someone during her last decades of life who will love her and nurture her as I someday hope to be loved and nurtured? I don’t know. I don’t think I will ever find out.

This woman was my first patient on my first day of work. I wish I could truthfully say that since then I have learned to distance myself from my emotions while maintaining the optimum level of empathy, straddling the line between friend and doctor. I can’t. I’m not even a doctor. I haven’t seen that many patients. Worst of all, though, I still cry without fail whenever someone else cries.

Someday, I hope to be a surgeon — perhaps a pediatric neurosurgeon. But I worry that my emotions will be my downfall.

15F. October 6. I love routine. I have always loved routine. I have 12 color-coded Google calendars that I update nearly every day. I’ve been using the same color-coded note-taking system with the same brand of ballpoint pen since freshman year of high school. I always put on my left skate before my right, always tilt papers at least 45 degrees to the left before writing. I pick my nails when I’m bored. I binge eat Goldfish crackers when I’m stressed.

I love the nonstop hustle and bustle of routine, addicted to a calendar with minimal blank space. Staying busy forces me to compartmentalize and prioritize — school first, followed by family and friends, then research and work and figure skating and the occasional gym session. Sometimes, though, I forget to call my parents back after weeks of silence. Sometimes, I cancel dinners or coffee because I fixate on that one neural pathway I can’t remember but am nearly positive will show up on the exam. I worry that, soon, routine will no longer be possible, that I’ll be on call in the hospital, sleep-deprived, barely trained, and someone will come in with a head wound that I am not equipped to treat. I worry that I’ll be in surgery when my kid falls at the playground and an ambulance is called. I’m bad with surprises, even worse when my routine fails to produce desired results.

My routine has always been my comfort. But these past few months working at DHMC have pushed me emotionally, much further than what I thought was my tipping point. I can no longer count on seven hours of sleep because my late-night thoughts drive me wild. I can no longer depend on a last-minute hyper-focused study session because I keep wondering, who is taking care of that woman with a failing memory?

Sometimes, I am tired of being alone (Aren’t we all?). I miss the naivety of childhood (When did our futures grow so unsure?). I yearn for the certainty of routine, the foolish notion that I’ll be okay, so long as I plan every hour of every day.

As I write this, I’m sitting in Moore Hall. It’s 8:51 p.m. I’m waiting for my subject to finish running the experiment that I’ve been working on since freshman winter. I’ve already eaten one bag of Cheez-Its and am debating starting a second. I worry Cheez-Its have become my new goldfish.

After the time commitment of sorority rush, the mental exhaustion of studying for quizzes and the physical pain of powering through figure skating practice, I am thankful that work this afternoon at DHMC was cancelled. Today, for the first time since term started, I spent two precious hours of my day lying in bed, watching a mindless romcom, with grades and medical school and my future boxed up and pushed to the corners of my mind.

My subject is almost done. I open up my Google calendar and see an empty two-hour block that used to say, “DHMC: Memory Clinic.” I fill the blank space with “NETFLIX!” because that moment, that short-lived departure from routine, should be remembered along with the others.