Abstract

In lieu of an abstract, here is a brief excerpt of the content:Being the DifferenceJake BeeryThat day started just like many others. It was a cold, wet day in March spent anxiously answering and reviewing hundreds of USMLE STEP 2 practice questions for my exam just a week away. Except that Sunday would be something different. Looking for any excuse to take a break from my personal mental marathon, I picked up a call from my dad. He had just spent the past six weeks wheeling my mom to near-daily appointments at the Mayo Clinic for treatment of her metastatic ocular melanoma. But now, with them back home, I had hoped for a short reprieve in the story of her cancer journey—for me, and for all of us. Instead, I listened to him explain how, less than 24 hours after coming home, my mom would be entering a hospice house in our hometown. Unable to control symptoms by themselves, my parents made the choice they felt would be best.Left with more questions than answers, a day later I found myself on a red-eye flight touching down on a snowy Minnesota runway. Inside waiting was the rest of my family, whose happiness to see me was unmistakably weighted down by similar hours of lost sleep. Together we shared as much time as we could with my mom, grateful she was able to meaningfully communicate when most other tasks proved unbearable. And that would be how she passed, surrounded by her closest family. Gone was my mom, my best friend, and the one person who I felt truly knew what it meant for me to be in medical school.The days that followed flowed in a melancholic blur. While I felt I knew so much about the time before hospice through talking with my mom and reading too many Kaplan-Meier curves, I was lost in the reality of losing a loved one for the first time. But as support poured in, time seemed to ease up. A close family friend who worked with grieving families as part of their profession told me, "In times like these, people will say things that seem strange. That's okay. Just try to listen to how much they care." And listen I did, savoring the minutes-long escape of listening to stories of a life well lived. Each time doing so, I felt the pull from the unknown to a place of unfortunate familiarity. Without much reference to how life feels after the loss of a parent, I cautiously stepped forward to face the rest of life's chores thrown at me.First came the rescheduling of STEP 2, reworking my study schedule, and yet more practice questions. And with it came my first struggles. While prior to flying home I could answer and review over 150 questions on a good day, I found myself unable to complete more than a single 40-question block. Every ophthalmology, oncology, and critical-care question transported me from the realm of abstract patients back to the beige waiting room of the hospice house. Gone was the joy of memorizing medical minutia. Originally, studying filled me with a sense of pride, furthering my dream of becoming a physician just like my mom had unintentionally inspired me to be. But now I didn't feel any of that. I despised every minute spent with my laptop open. But knowing the weight of board exams on a medical trainee's life, I pushed on. Outside of UWorld questions, I tried to make my world as normal as it once had been. I went on runs, got cappuccinos, and sat with my best friends. I did all the non-urgent things that still felt so important. And while I still [End Page 70] desperately missed my mom, multiple-choice questions gradually got easier, and the second chapter of my medical school career came to an uneventful close in a stuffy suburban testing center. And with it came my return to the wards.As a now 4th year medical student, I was set to begin a month-long rotation on the inpatient palliative care consult team at a busy, tertiary care medical center. As usual, the first day...