I entered medical school absolutely certain of one thing: I didn’t want to be a psychiatrist like my father.
I’m sure someone like Freud could come up with a deep therapeutic reason for why I didn’t want to follow in my father’s footsteps. Or, maybe I could ask the surgeon who belittled me as a medical student and asked, “Are you going to go into the same field as your daddy?” as he looked down at me awkwardly holding a retractor during an operation. But all I can come up with is that my dad’s shoes are big, and I was afraid to try to fill them. It felt like a goal I couldn’t achieve or a competition I simply wouldn’t win. And I don’t like losing.
Don’t get me wrong, though, I respect my father immensely. He is an expert in his field of addiction and is a researcher with hundreds of publications to his name. A lot of people at my medical school knew him personally because he had trained there. One time, I went to an addiction psychiatry meeting, and someone saw my last name on a name tag and asked me if we were related. I tried to say no rather vigorously, but apparently in protesting, my mannerisms, humor, and sarcasm made it even more obvious that I was my father’s daughter.
Avoidance, to me, felt like the safest tactic. Since I was fascinated by the brain, I tried my hardest to veer toward neurology instead. In medical school, I joined the neurology interest group, sought out neurology mentors, and even did neurology research. But I kept finding myself feeling happiest when I could talk with patients and hear their stories. Even when I was supposed to focus on a procedure or make a tricky diagnosis, I just wanted to pull up a chair and talk to the patients about their lives.
I remember, during my internal medicine rotation in my third year of medical school, I was taking care of a patient named Rosa, a 75-year-old woman with worsening chronic obstructive pulmonary disease (COPD), a progressive lung disease. Every morning at 6 a.m., I went into her room and asked, “How are you doing this morning?” She would smile, seemingly not minding that I’d woken her (unlike the patient who taped a note to the hospital door that read, “Do not bother patient until 6 a.m., especially med students”). Without skipping a beat, she always said, “Good morning, Cookie.”
I found her greeting endearing; it made me think of my grandmother, who like Rosa also loved red lipstick and talking about her grandchildren.
One morning, my medical team got a page: “East Pavilion 5-512. New onset chest pain. Please come evaluate.”
“That’s Rosa’s room,” I said out loud to no one, as the team had already picked up their pace to climb the stairs to see her. As we approached, I heard the sound of her screams — feeble but urgent.
Once in her room, I locked eyes with Rosa, who looked nothing like she had a few hours earlier, when we had joked with each other. Now she was crying and sweating, almost childlike in her discomfort, begging for someone to listen to her. In fact, she was screaming for someone to listen.
The residents scrambled to complete the typical diagnostic steps for chest pain, pulling down the top of her gown and adhering the EKG machine’s electrodes to her sunken chest to ascertain her heart rhythm. Someone came to draw blood so as to see if she had elevated troponin, a protein that spikes when the heart muscle has been damaged. Someone else ordered an X-ray of her chest. No one noticed that Rosa was upset that her chest was exposed. No one made any effort to cover her up.
I was in the corner of the room, out of everyone’s way, watching the scene unfold like following a checklist of “what to do for chest pain.” At each step, the residents told me — I was the only medical student in the room — what they were doing. They wanted to teach me something, even in the controlled chaos of the emergency, and I wanted to absorb it all. But I couldn’t stop looking at Rosa’s face.
Suddenly she coughed, which provoked an ear-piercing “Ay, dios mio,” as she looked at the ceiling, presumably praying to God. She spoke English fluently, but now the only words that came out through her pain were in Spanish. Sometimes there’s safety and comfort in a person’s native language.
I felt a pit in my stomach, and I took it as a sign to do something. Ignoring the unspoken rules of medical professionalism, I ran to Rosa’s side, making sure not to get in the way of the real doctors. Then I asked her permission to hold her hand, and she nodded OK. I also rearranged her robe so that her chest was not so exposed, again being careful not to interfere with the team’s maneuvers. After that, I squatted down to her so we were at eye level, and I said in a quiet whisper, “It’s going to be OK.”
Rosa replied, “Thank you, Cookie, for caring about me.”
I instantly felt defensive of the team, knowing that they cared, too, but as I looked around the room, I realized Rosa’s point. It wasn’t as if there was something wrong with these doctors, or this well-regarded teaching hospital, or that anyone was doing the wrong thing. They were all trying to save her life. But in the chaos of the beeping monitors and the diagnostic steps, they forgot that it was a human being whom they were saving.
I couldn’t stop seeing the person, in this case Rosa. I wondered if, in the future, I would be able to distance myself as my colleagues seemed able to do. And at the same time, I wasn’t sure I wanted to do that.
Maybe that’s what drew me to psychiatry. Not only is it a field in which patients feel seen, but within it I felt seen, too.
Excerpted from “How Do You Feel?: One Doctor’s Search for Humanity in Medicine” by Jessi Gold. Copyright © 2024 by Jessi Gold. Reprinted by permission of Simon Element, an imprint of Simon & Schuster, LLC. All rights reserved.
Jessi Gold, M.D., M.S., is the chief wellness officer for the University of Tennessee System and an associate professor of psychiatry at the University of Tennessee Health Science Center.