A Detective in Search of a Diagnosis

The summers, spring breaks, and Christmas vacations in-between my years at Taylor University were spent working through the night as a patient care assistant (PCA) at the Children's Medical Center (CMC) right here in Dayton, Ohio. I spent time in the pediatric intensive care unit (PICU) restocking linens, checking hourly vital signs, fetching blood products from the lab, and of course, cleaning my share of bedpans and emesis basins. The best part was of course, the kids. I decided to forego summers of lifeguarding and camp counseling to see if I enjoyed the hospital enough to pursue a career in the medicine. I fell in love immediately. I fed babies at four o'clock in the morning, played Nintendo with kids who were starting to feel better but had a hard time sleeping in a strange bed, and tried to help families who had an ill child, something no one wants. Two weeks into my new job, I remember telling my mom that I was sure I wanted to be a doctor. I knew I wanted to be the one to help those distraught families to find some hope. So I asked tired residents countless questions, begged permission to watch procedures that made me queasy and my face ashen white on more than one occasion, and studied hard in rural Indiana in hopes to read an acceptance letter to medical school someday.

Why the history of my life as a sometimes weak-stomached orederly? I began my pediatric clerkship this month and finally returned to CMC, visiting the PICU for the first time in years. This time I wore a short white coat, didn't have to clean a single IV pole, and laughed a little chatting with coworkers about old stories. It was fun to remember how much I wanted to be where I am right now, a medical student fourteen months away from attaching letters to the end of my name and having people ask the question, "Doctor, what should we do?"

I think I may finally be beginning to realize what's attracted to medicine for the last eight plus years of my life. I love stories. I love to tell and hear them. And I love to remember them. D.T., my best friend who lives in New York, often calls just to tell the same old story of coaching Justin to third place in finals of the backstoke together. He writes me postcards of all the exotic places he visits, outlining three-sentence accounts of his adventures. Frederich Buechner, a Pulitzer prize-nominated author, writes that we are the sum of our stories and that our tales communicate a deeper level of meaning about who and what we are. Little did I know that story-telling and more importantly story-listening would be my profession of choice. As a physician I listen to stories and help direct a patient and other eyewitnesses to give me the details of the story that help me uncover the diagnosis the patient needs for the treatment team in order to provide correct care in a timely manner. We also say so many things without using words. Facial expressions, tears, and ear-tugging are all important diagnostic clues in pediatrics where verbal communication may be limited because of a patient's age. Physicians are in many ways detectives of sort, observing, inquiring, and listening.

So for the next couple of months, I'll hopefully be able to play another round of Donkey Kong, wear funny ties, and smile. I have to listen to and watch my patients, their parents, and senior physicians in order to learn how to care for sick children and to emulate being a story-listener, a detective in search of a diagnosis. Mr. Buechner is right; there is incredible worth in the plots of our lives.

Andrew Jacques ('05)