18 years later, I looked at the name of my next patient on the way into a room and stopped. My internship flashed before me. “It couldn’t be,” I thought. I looked at his age, 24 years old.

Forgetting about why he might be there, I told him how exciting it was to see him again. After a few recollections from 18 years ago, his story started to fill the room like a thick fog.

He had finished high school and had started college with dreams of going into medicine. A few months into his first year, his father died. As the oldest sibling, he made the difficult decision to drop out of school and get a job to help support his family. His mother’s health soon declined, and he became her primary caretaker while working minimum wage jobs. His mother had recently died, and through a series of bad decisions by family members, they lost their house, and he was now homeless. He had been sleeping in the park across the street from the hospital and had been assaulted, which was why I was now sitting here with him 18 years later.

I felt helpless and devastated that his life had gone in this direction. So many of our patients in the ED face shocking adversity every day, but this was personal. He was my first patient as a real doctor after all, and I felt like I had failed him.

I never know what to do with the darn twitter. So I don’t. But, I just make go back and try again because yours is just hilarious.

Ha ha!

And I am taking your twitters – two of them and posting in my blog… because just seem apropos for my ss blog given all the uro posts in past.

But if you don’t want me to use your twitter then I will remove it. But it’s going up up right after this -hope okay.

Senior year rotations there was an orange domestic short hair cat in and out of the ICU because of mycotic encephalitis (candidiasis). It had been hospitalized for a couple of weeks and was recovering from surgery to relieve intracranial pressure when I was assigned the case during my small animal med rotation. I read the file through before I ever saw the animal, and couldn’t believe what the family had put this animal through in an attempt to save it. I thought it a cruel situation and was ready to hate the owners … and then I met the cat. It was the sweetest cross-eyed, ataxic, head-tilting fighter you’d ever want to meet. The family, far from being the well-heeled denialists I was expecting, were involved and quite realistic about what the percentages were for this cat’s recovery. They visited every day, insisted on realistic appraisals from the veterinarian in charge of the case each time they visited, and personally assessed the cat’s well-being and quality of life. They insisted on knowing how the cat acted when they weren’t there and made it a point to speak to low-life fourth year drudges like myself as well as the head clinician to make sure the cat wasn’t suffering during the times weren’t there to see it themselves. The animal persisted in maintaining a bright attitude, good appetite and (marginally) improved lab work during the course if its what turned into an almost six week stay at the hospital, and finally left to go home still slightly cross-eyed and ataxic, but a good pet with a wonderful home. I later heard that the cat maintained neurologic deficits at its three month check up, but had returned to a regular routine of eating, sleeping, using the litter box and playing with cat nip. I learned from that case not to pre-judge a patient (or its owners) from a file and percentages.

Which is probably more room than I should take up in a comment, and definitely two short of the “my three patients” theme, but probably had the most profound impact of anything I did in vet school.

Thank you for a most touching post, Dr. Whitecoat.