A 58-year-old woman with no significant past medical history presents with newly diagnosed gastric carcinoma. What symptoms does she have? What are the physical exam findings? How are her labs? Did she undergo any imaging? I wondered about the answers to all of these questions but could not bring myself to ask them because the 58-year-old woman was my mother.
One afternoon during my internal medicine rotation, my father had texted me, “Please call when you get the chance.” My mind shifted to the last time he had sent these very words after my grandfather had missed a step while exiting the bus and struck his head on the pavement, developing an intracranial hemorrhage that permanently compromised his ability to communicate. For the remainder of the workday, this memory ebbed and flowed in the depths of my distracted mind, sweeping to consciousness my worst fears.
When I arrived home, I called my father. “Mom has a tumor in her stomach.” I suddenly recalled that the last time I had spoken with my parents, my mother had mentioned that she recently had several biopsies collected during a gastroscopy. I had neglected to check in, assuming the results would be benign. I assured my father with a false sense of confidence that my mother would be fine, breaking a well-known rule in medicine to not make promises you cannot keep. I realized in that moment the polarity within embodying the role of a medical student and daughter simultaneously.
Over the next few months, my mother completed her first chemotherapy cycle and underwent two surgeries, the first of which removed eighty percent of her stomach. The second surgery became unexpectedly necessary when she developed an internal hernia, and she spent the holidays not only in excruciating pain but also alone due to COVID-19 restrictions. Three- thousand miles away, I was determined to do everything in my power to help my mother and the rest of my family. Although my parents were adamant that I continue with school unless the situation worsened, I was firm on my decision to return home for several months after my clinical rotations, intent on being there with and for my mother as well as the rest of my family.
During the last few months of clerkships, it felt as if I were leading two parallel lives. On the one hand, I was a medical student striving to learn how to provide the best care for her patients. On the other, I was a daughter who needed to help her family persevere through the most challenging time we had ever collectively experienced. I was terrified but also cognizant of my unique position in a family of engineers. As the only one with experiences in medicine, I was grateful that I could support my family by providing insight on reports from the hospital and discussions with my mother’s oncologist. Despite the distance and circumstances, I had never felt more connected to my family.
The first time I saw my mother after her cancer diagnosis was almost 6 months since that day on internal medicine. Although I had “seen” her almost every day during those months through video chatting, seeing her in person was different. I was unprepared for how significantly frailty and fatigue dominated her now tiny frame, her previously radiating vibrancy muted to a dull echo. At the time, she was still recovering from her second surgery. Her incision site had not yet healed even after 8 weeks, which had been delaying the start of her second chemotherapy cycle.
I was grateful to return home for several months even though I was only able to do so because I was scheduled to take my USMLE exams during that time. During the day, I stayed with my mother as much as I could. For the moments I was not next to her, I set up walkie-talkies so she could call for help at any time. At night, my father and I shared the responsibility of taking care of her unhealed wound; I was responsible for cleaning it while he carefully applied new packing material and the outer dressing. My sister would visit frequently from her home nearby, bringing fresh kale from her garden and food she prepared that reflected her commitment to optimizing our mother’s nutrition. We were a team.
My mother’s second chemotherapy cycle came and went, her final day of treatment happening to coincide with my birthday. I picked her up from the infusion center that day and watched as she walked slowly out of the facility towards me with a certificate and stuffed animal in hand. “I’m so proud of you,” I said. As we drove back home where my father and sister were waiting to celebrate the end of a chapter in what we knew would be an ongoing journey, I glanced over at my mother, who had closed her eyes, and wondered what she was thinking.
When we were all together, the pain we each experienced differently and separately momentarily dissipated. We healed one another through simply co-existing, processing our emotions through conversation and working together in aiding my mother’s recovery. We shared the same goal, fighting for her and with her in this cruel battle, doing everything under our control in an attempt to influence the unpredictable. Connection was our superpower; with it, hope was possible.
--Beverly Yu, Yale School of Medicine, New Haven, CT