Mahalo

From the moment I met her, I loved her. We had an instant connection. She was my first real patient in my sub-I.

She was Hawaiian; had tribal tattoos all over her body. Warm and motherly, middle-aged; she had many children. They were mostly

homeless, like her. They were young girls, many pregnant. She had been addicted to Meth most of her life; was clean

for the first time ever, this year. I’ll never forget the day,
right before she left AMA. She wasn’t angry; she was honest.

The whole team was in her room when she delivered her
impactful rant. She directed her gaze at me the whole time.

“Nothing you do here matters. Even if I do get the right
dosage, or breathing machine, I’m going back to the streets.

I’ll be breathing in the dust from that air every day.
When I walk out of this place, nothing else will matter.”

I was a young medical student doing everything I could. I cared
deeply about health equity. How could I keep from becoming jaded?

How could I hold on to idealism and principles? Not become convinced
nothing I did mattered, when my own patients were proving it to me?

I want to be able to evolve, change, not become bitter, but in
the county hospitals, I see it over and over and over again:

Nothing you do matters.
Nothing you do matters.
Nothing you do matters.

How many times will I try, then nope! Be back to losing hope? I knew
my patient didn’t have much longer. She taught me a tough lesson:

There was no way back to belief, without going through the grief.

Notes from the interview that inspired this poem:

She wanted her poem to be about her experience working with a particular patient she felt a deep connection with during her fourth year of medical school. After several days of building trust and rapport with the patient, she thought she had convinced the woman to stay long enough to find the appropriate dosage for her heart failure medication, and to have her leave with a nebulizer. Instead, the patient ended up leaving AMA, without either. She described a heartbreaking interaction where the patient repeatedly told her, “nothing you do matters.” She went on to tell me that it was especially evident working in the county hospitals, with patients who were uninsured, or had other economic or personal barriers impacting their health. “I want to find hope in these stories, but I’m not sure there is any. I care deeply about health equity. I do everything I can to find solutions. I need to hold on to some degree of idealism and belief that our work does make a difference, but how can I do that when I literally have patients proving me wrong?” she said. “And I keep seeing it over and over and over again.”

Interviewee: Anonymous, Resident
Listener Poet: Jenny Hegland