CCPA Summer Series 2017: Aurora Lewis ‘19 with a Pediatrician, Princeton, NJ

Getting Somewhere: My Experiences Shadowing a Pediatrician
Marie spends her days in a wheelchair. She is hard of hearing and has lost her sight, but is aware of some dream-world that the rest of us are insensible to. She talks aloud, even reaches out to things with gnarled fingers, and often I can scarcely understand her.  In her few lucid moments, however, she shows that there remains, somewhere in that shambled body, the trappings of a sweet, trusting soul. When I hold her hand, she instinctively moves towards the warmth, commenting on the softness of my skin. A couple of times, she bestows a rusty kiss on my cheek. In her fragility, she reminds me of a baby bird, shivering when her nest of blankets falls from her knees, opening her puckered mouth in a plea for water.
The children I have encountered during my shadowing internship with Dr. Altshuler this summer are in some ways similar to Marie, whom I visited as a hospice volunteer throughout my sophomore year at Haverford. Many of them, especially the newborns, possess that same helpless, fragile quality, and seem to wonder at small things, just as Marie seemed fascinated by the warmth and smoothness of my hands. Infants grab, half-fascinated and half-afraid, at the light of the otoscope, and toddlers will stop and stare at you, too, fascinated by your prominent, developed, adult features.
“Oh, look at the young and pretty girl,” Dr. Altshuler laughs, whenever the kids stare at me, mouths half-open, unabashed in their curiosity.
That said, Marie and Dr. Altshuler’s patients are also different in many ways. It strikes me that while these children are entering life, Marie is leaving it; and while you know you are helping, rather than hurting, the little boy who cries from a vaccination, as Marie deteriorates over the weeks, clawing at the blankets and whimpering in pain, you know that pain is genuine, and that is not your job to ease it, but to rather to act as a witness, to assure her she isn’t facing it all alone. Pediatrics, as a practice, is incredibly empowering, because you feel the strength of your own agency, understand that something–and often a whole list of somethings–can be done. Hospice is an entirely different matter; while you can visit for an hour or two, and bring a poem to read as a distraction, or even simply sit and try to stitch together a fragmented conversation, you know that the nature of your job is in a way to sit and do nothing. The end is inevitable.
And though death is a necessary part of life, and, arguably, an important piece of the dialogue surrounding medicine, hospice wears on me in a way that pediatrics never does. Part of me dreads going to hospice each week, to see Marie, to try and help while also noting what has deteriorated–how much weight she has lost, how many times she cries in pain. With my internship this summer, it is completely different. I smile, and often. Babies blink at me with wide, wondering eyes, and I imagine the lives they will live–long, full ones. There are the serious cases, too, patients with deceased parents, patients with depression, patients with Autism; yet still, it feels different than hospice, because you can see people getting through their pain, you can see where you fit in that recovery, and it doesn’t feel helpless. Even when I’m just helping out the nurses, observing vision tests or answering the phones, I feel like smiling. Perhaps it’s the newness, or my own tendency to marvel at the ordinary, but I like to think it’s something else. At hospice I witnessed life leaving. I watched as patients withered slowly, like trees before fall, curling in on themselves. But at this office, you can usher life right in through the door. You can watch Dr. Altshuler examine a patient, or quickly sidestep a toddler wobbling down the hall, and instead of everything seeming stagnant, it feels like you’re getting somewhere.