you go dizzy until you fall

Frequent episodes of syncope have flip-flopped my role in the health care system from physician in training to patient in waiting.

The rhythm of my day continues to beat with unraveling the mysteries of disease. I join my classmates in lecture as a veritable parade of pathology marches before us. With the advances of modern technology, we are no longer limited to word-descriptions of disease, but youtube provides us with streaming footage of embodied illness. As dispassionately and professionally as can be mustered, we gaze from the dance-like possession of Huntington's Chorea to the drunken-esque stumbling of cerebellar ataxia.

I am not sure anyone quite knows how to acknowledge what it is we are viewing. Some of our lecturers will try to soften the blow by making quips (Neurology: diagnose and adios). Others will tell us that the patients often look worse than they actually are, and maintain a high quality of life. Perhaps the best reaction we can hope for is a moment of silent acknowledgement before pushing the powerpoint forward.

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I have had 12 doctor appointments, 2 urgent care visits, and 1 Ambulance-mediated ER visit since the onset on my presyncopal episodes this past August. To date, blood work, EKGs, aggressive behavior modifications, and enough drugs to put a smile on Pfizer stockholders face have not eliminated my chest pain, fainting, and other symptoms. This Friday, I will add an echo-cardiogram and a holter-monitor test to the collected data about my body.

I tend to present the persistence of this illness as "second year-itis". This may not be entirely false - medical students are renown for diagnosing their stomach aches as dissecting aortic aneurysms and nighttime distraction as late-onset ADHD. It doesn't help that many of the post-mortem cases we review are of men and women in the prime of their youth. (It is irresistable to keep my mind from wandering to a self-diagnosis of mitral valve prolapse or Ehlers Danlos syndrome.) We have just enough information to be completely panicked and in a practical medical sense, entirely useless.

But, despite what I say out loud, I am anxious to resolve this and name what is going on inside of me. Still, the experience has not been all bad - support in the form of an exceptional framily of BC alums and Harvard second years has huddeled around me - to accompany on medical appointments and serve as gentle reminders that maybe (just maybe) I should not jump to the conclusion that I have inherited an extremely rare collagen disorder, but rather should remain in the waiting.

The waiting.

For a future physician, this practical experience of allowing time to pass in the unknown abyss may be the most valuable lesson I earn for my future patients.

Empathy, it seems, is not easily taught (even with youtube).

I'll be sure to keep updated on what comes next.