Gold Foundation Essay
Untitled
Benjamin Lampson
I t was an event that I knew had to
happen. The aphorism told me that it
was as inevitable as taxes; the brief candle
must extinguish. Despite the inescapable
nature of the event, I never considered a
course of action, or more importantly a
course of thought, that I would take in
the situation. I never treated the subject
with the appropriate gravity that true
preparedness would have required;
instead, I mistakenly awaited it with
nothing more than the mild dread that a
child has while waiting in the dentist’s
chair, expecting the ineluctable pulling
of that first tooth. The less I was prepared
for the situation, however, the more I
learned when it happened. I was two
weeks into my clinical rotations when a
patient died under my care.
To cure sometimes. I walked into the ED
examining room. Marie was sitting
upright in bed with a pillow propping
up a head of neatly curled milk-white
hair. Her only living kin, a son, was at
her side. “Are you the doctor?” he
asked. I had a prepared self-deprecating
answer for that question that I had
heard so many times previously. “No,
I’m just a medical student, but a doctor
will also be in to talk to her.” An
unusually active 92-year-old, she told
of an itchy, scratchy throat beginning
three days ago, which progressed to a
cough and difficulty breathing within
two days. Decreased breath sounds on
exam; heterogeneous opacity in left
lower lobe on x-ray—I was piecing
together the picture. This was
pneumonia and could be treated. I was
confident; after all, I had recently
received a PowerPoint lecture on this
affliction. So this is what it feels like to
be a doctor!
To relieve often. Marie was admitted that
night, and over the next three days I
learned that my optimistic take on the
situation was perhaps mistaken. Her
Second-place essay.
Mr. Lampson is a fourth-year medical student,
Duke University School of Medicine, Durham, North
Carolina.
Correspondence should be addressed to Mr.
Lampson, 200 W. Woodcroft Pkwy. #46-B, Durham,
NC 27713; telephone: (919) 402-4250; e-mail:
(bll4@duke.edu).
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oxygen saturation steadily, slowly care for his mother; perhaps he knew
dropped, as if it were a clock ticking off what was coming and wanted to prepare.
her remaining hours. I spent more time To comfort always. That night I could not
in her room. I learned about Henry, her sleep. I was disturbed by the fact that
husband of 50 years, now deceased.
what I once thought was impossible
When Marie became too breathless to
was now clearly inevitable. A bacterial
speak, her son would pick up the story.
pneumonia, and yet all the -cillins and
When she declined to eat for two days,
-micins had done nothing. If it was the
we discussed foods that she missed the
21st century and an almighty arsenal of
most. Her favorite was chocolate milk;
her son asked me if it would be possible antibiotics still failed to cure pneumonia,
to get her some. Locating chocolate milk what was the point of being a doctor?
on the ward was a task I had never before Since I could not sleep, I decided to start
faced, and I had no PowerPoint slide to prerounding early and went to visit
direct me on this one. When I finally Marie. The sun was not out yet; the only
found a carton and returned to the room, light in her room came from the soft
Marie accepted it readily. With his glow of a muted television, a weakened
mother now content, her son told me lambent spotlight on her face. She smiled
that he was going home for the evening, at me. “Hello, Henry, I have problem,”
leaving her side for the first time since she quietly said, in a voice that was high
admission. He had barely slept in the past and scratchy and not her own. Calling me
days, and now he needed relaxation, by her husband’s name, an acute decline
respite, rest—relief. Perhaps he was in cognition, this was delirium. Possible
finally assured that someone would still causes include infection, metabolic
be there who would compassionately derangements. . . . Stop.
The Francis A. Velay Humanism in Medicine Essay
Contest Presented by the Arnold P. Gold
Foundation
The Arnold P. Gold Foundation is a not-for-profit organization founded in
1988 to nurture and sustain the time-honored tradition of the compassionate
physician. Today, students, residents, and faculty participate in at least one
Gold Foundation program at 93% of our nation’s medical schools and at
schools abroad. Its programs and projects are derived from the beliefs that
compassion and respect are essential to the practice of medicine and enhance
the healing process; the habits of humanistic care can and should be taught;
and medical role-model and mentor practitioners who embody humanistic
values deserve support and recognition.
In 1999, the Gold Foundation instituted the annual Humanism in Medicine Essay Contest as a way to
encourage medical students to reflect on their experiences in writing. Since the contest’s beginning,
the Foundation has received close to 2,000 essays from more than 110 schools of medicine and
osteopathy.
Contestants for the 2006 Humanism in Medicine Essay Contest were asked to respond to the
following quote from Hippocrates: ‘‘To cure often, to relieve sometimes, to comfort always.’’
Winning essays and honorable mentions were selected by a distinguished panel of judges. For the
sixth year in a row, Academic Medicine is pleased to publish the winning essays from the contest.
Although their essays will not appear in the journal, the Gold Foundation would like to recognize
third-place winners Kelly Doran and Kate Nyquist. This year, three essays share the second-place
honor; Benjamin Lampson’s appears here, and the other two second-place essays can be found on
pages 1110 and 1114 of this issue. The first-place essay will appear in the December 2007 issue of
Academic Medicine.
Winning essays are also published on the Foundation’s Web site: (www.humanism-in-medicine.org)
and in the Foundation’s DOC newsletter. For further information, please call the Arnold P. Gold
Foundation at (201) 567-7999, or e-mail: (goldfdtn@gold-foundation.org).
Academic Medicine, Vol. 82, No. 11 / November 2007

“Tell me your problem, and maybe I can
help,” I responded.
“I’m thirsty. I’d like some chocolate
milk,” she informed me. Out of all that
would happen that morning, this was one
event that I had prepared for; a carton
was in my hand. I placed it in her grasp.
She was too weak to lift it. I put a straw in
it and brought it to her mouth. She was
too confused to form a tight seal around
the straw. I unwrapped the plastic spoon
that lay next to last night’s untouched
dinner, and dipped it into the carton.
With an unsteady hand I brought the
half-filled spoon to her cracked lips. I was
not good at this, and most of the liquid
spilled into the wrinkles around her
mouth. The milk that did make it in was
gulped down hungrily. As I repeated the
act, I got better at it; halfway through the
carton she declined any more. “Thank
you, Henry,” she said. I placed a hand on
Academic Medicine, Vol. 82, No. 11 / November 2007
hers, and to my surprise she gripped back
tightly. We sat together in silent darkness
for a while, not staring at each other but
not looking away either, each aware of
the other’s presence.
I think that it was here that I first came
to understand the doctor’s job. To cure
sometimes. Diagnosis and treatment of
disease are cornerstones of the profession,
though they are neither always possible
nor always necessary. To relieve often.
By the nature of the job, physicians
often encounter people when they are
experiencing a rough patch on the path
from birth to death, and it is our duty to
make that path easier to tread. This could
involve, for example, curing ailments, but
could also include clearly explicating
diseases to patients, or using humor
to ease patients’ anxiety. The above
narrative illustrates that such duties also
extend to families, who partially bear the
Gold Foundation Essay
distressing burden of a person’s disease.
Even Marie’s steadfast son needed sleep.
To comfort always. The roots of the verb
convey a simple meaning: “con fortis”—
to be with strongly. It is the physician’s
assignment, but also our aspiration, to be
with the patient. This does not require
constant physical presence; rather, the
patient should never feel alone. Even if
unable to treat the disease, even if unable
to lighten suffering, physicians can always
be there for the patient, ensuring a caring
companion for whatever the future holds.
Marie died the next night with her son at
her side. When I arrived at the hospital
the following morning, her room was
already empty. Her son contacted me
through the hospital operator later that
day. When I spoke to him, he gave me the
closure for which I ached. “Thanks,” he
said, “thanks for being her doctor.”
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