Making a Choice

In Issue 70 by Quin Yen

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Photo by Sigmund on Unsplash

For some of the third-year medical students, simply putting on the white coat could make them feel at least one foot taller. Who could blame them? After two years of medical school, the students’ heads were filled with textbooks of anatomy, pathology, chemistry, organic chemistry, genetics and microbiology; so naturally, they felt ready to tackle all human diseases in the real world.

But the third year of medical school wasn’t just a transition from classrooms to clinical rotations in the hospital; it came with a busier and more rigid routine. Thus, Melissa began her day at six o’clock in the morning and left the hospital around six o’clock in the evening and had to be on call once per week. In the evenings, she read about the cases that she saw during the day until she could no longer keep her eyes open. Within a few minutes, she was sleeping like a log. Understandably, with this kind of hectic schedule, she hadn’t had time to call her parents.

One month after not hearing from Melissa, her mom started to worry. She felt as if she were left in suspense and imagined all sort of disasters that might have happened to her daughter. Finally, on the Labor Day weekend, the no news is good news saying lost its charm; she decided to call. To make sure not to wake Melissa up too early, her mom waited until ten o’clock in the morning. Her heart raced while listening to the dial tone ringing. When she heard Melissa pick up the phone, she spoke quickly with palpable anxiety and measured caution. “Hi, Melissa. It’s Mom here. How are you? Are you okay? Did I wake you up?”

“No, Mom. It’s perfect timing. I’m off today. I actually planned to call you later. I’m sorry I haven’t called you sooner. It’s been really busy.” Melissa’s reply was a bit out of order and apologetic.

Nonetheless, her voice, like a fast-action tranquilizer, made her mom’s palpitation fade away. Once again, she knew that her worries were “unfounded.” She said, “Oh, I know you’re just busy. But I was so worried about you. Don’t be sorry. It’s my own nerves. When I haven’t heard from you for two months, I start to think something bad must have happened. I know it sounds silly, but it’s just mother’s nature, and I guess it’s an incurable parental syndrome.”

“Don’t worry, Mom. I’m fine. Actually, I was going to call to tell you that I really enjoy my clinical rotations. I especially like seeing patients, making diagnosis and coming up with treatment plans. The fast-paced routine suits me well. It’s much more interesting than just reading textbooks. And remember I used to like detective novels? Well, I still do. I found that making a diagnosis is quite similar to solving mysteries.”

“Oh, I can see they’re comparable in a sense. I’m glad that you think that way.”

 “But there is one thing I don’t like.”

“Hmm, what is that?”

“I don’t like sticking patients with needles, for example, to place an IV or to draw blood.”

“Oh, you’re like me. I can’t stand watching people drawing my blood,” Mom said, turning her head to the side and closing her eyes, as if someone were about to stick her in the arm.

“And there are other things I don’t like. For instance, when I saw a patient come into the emergency room with a fractured limb or an open wound in the chest with blood all over the body, or when I had to perform chest compression on a patient, I would feel ill and dizzy. Often, I tried to insert a needle into sick patients’ veins, but these patients were really ill from weight loss, or dehydration, or chemotherapies, and it’s hard to see or palpate any veins; after trying over and over again, my hands sweat inside the gloves and became too slippery to even hold a needle,” Melissa explained.

“I can see how difficult that is,” her mom said as if she saw a vivid picture of Melissa sweating in front of her.

Melissa took a breath and continued. “At first, I thought it was a matter of practice, but it’s been more than two months, and my anxiety about seeing needles and blood actually gets worse. It’s…almost like I have PTSD. Now the thought of placing an IV makes my heart race and my hands tremble.” She wiped her hands on her shirt.

“That sounds serious,” her mom said. “But do all doctors have to use needles in their practice? Can you avoid using needles?” she asked, but her tone sounded more like proposing an idea than questioning.

 Hearing her mom’s words, Melissa sighed a big relief. “That’s exactly what I’ve been thinking about lately. I’m so glad that you think the same way. I feel less pressured now. It’s not you, but my own pressure to please you and others. I don’t even know who these others are, but I used to think that I had to choose a specialty that would make people proud.”

“No. Don’t choose a career to please your parents, or anyone else. Don’t chase something just because it’s prestigious or lucrative. What’s good for others may not be good for you,” her mom said.

 “Thanks, Mom. I’m glad that you said this. I feel better already. We’ll have two years of clinical rotations to try out different specialties. I hope I’ll be able to figure out which one is the most suitable for me.”

“That’s right. Take your time and don’t rush,” her mom said.

*

After the phone call, Melissa started to comb through the possibilities more carefully, and divided them into three categories: surgical, medical and others. She listed the pros and cons of the specialties on a sheet of paper and compared them. Melissa couldn’t picture herself opening up a chest or an abdomen or popping out a hip joint to replace it. So, all surgical fields were out. Since most medical fields also involved aggressive treatments such as chest compression, bladder tube or feeding tube placements, needle insertions for IVs, or for joint fluid or pleural fluid aspiration, she crossed these out too. Eventually, she narrowed her choices to three potential specialties: psychiatry, pathology, or radiology.

Among these three options, Melissa put psychiatry at the top of her list because she liked doctor-patient interaction and making diagnoses. Although she preferred not to work under a microscope to read biopsy slides or to read X rays in the dark all day long, she didn’t exclude these completely. In case she wouldn’t like psychiatry after trying, she would consider one of the two as a backup. In a way, both pathology and radiology had a detective touch, too.

This preliminary assessment made Melissa feel more settled. She lay back and casually picked up Agatha Christie’s Murder on The Oriental Express. About halfway through, she read a Hercule Poirot’s quote that she hadn’t paid attention to before: It’s the psychology that I seek. She read the line over and over as if it were written for her.

Is this my fate? she pondered. Her detective mind paired with her sensitive personality would make her a good listener and a problem solver. Didn’t an ancient Greek philosopher say, “character determines fate”?

Without further hesitation, Melissa decided to allocate her four months of selective rotation in psychiatry to try it.

*

By the end of January, her last year of medical school, Melissa had spent three out of her four selective rotations in psychiatry. Not only did she enjoy these rotations but she also liked the doctors she had worked with who uniformly commended her as an exceptional listener.

The doctors’ positive feedback boosted Melissa’s confidence to apply to her current program at the Northeast Hospital. Although she also applied to ten other programs as backups, she knew that the Northeast Hospital position would be her best bet, especially if  being a “good listener” could be considered a weakness at interviews. Who would appreciate someone who doesn’t talk much?

Yes, her strength is like a double-edged sword, Melissa knew. She felt the urge to pray at a nearby church. Even though she wasn’t a regular churchgoer, she had prayed from time to time, whenever she thought it was necessary. She didn’t feel too bad about this because it meant that God had a place in her mind and that’s true too.

 February was the month before the residency programs when doctors decided on applicant acceptance, and Melissa strategically scheduled her last selective rotation in psychiatry so that the doctors would remember her better and hopefully place her at the top of their acceptance list. Right before her rotation began, out of nowhere, a “golden opportunity” appeared. Dr. Thomas, the Chief of Psychiatry, changed his clinical schedule with his colleague so he would work with medical students on the inpatient unit. When Melissa learned about this news, she was secretly pleased. She knew that to work with the chief of the service would give her a chance to establish a personal connection with him. Everybody knows that the chief’s opinion carries more weight in resident selection, so the timing is perfect, God-given, and pure luck! Fate again. Now, it was up to her to perform.

In fact, before February, Melissa had heard about Dr. Thomas. Medical students said that he was a good teacher, and many of his patients and nurses praised him as a good doctor. Exactly how good is he? Melissa thought. Well, now she would have a chance to find it out. She told herself, “Even if I am not chosen, to work with the best doctor for a month will be worthwhile.”

*

On the first day of the February rotation in Psychiatry, Melissa found out that she wasn’t the only student; Kate, another student, also chose to rotate in the same department. Although they had not worked together before, Melissa had heard about Kate. She had been on the U.S. Olympic Rowing Team for many years, so her admission to the medical school made the front page of the school online newsletters with a photo of her rowing in the Cambridge Charles River. Who wouldn’t be proud to be a classmate with an Olympian? This news seemed to give some of the students a reason to boast about the coincidence.

Nonetheless, meeting Kate for the first time outside of Dr. Thomas’ office, Melissa’s delight turned into fear. She couldn’t help but scan Kate from head to toe with a detective eye: Kate’s tall and slim figure, bright blue eyes, broad shoulders, and her sharp determined jawline gave her the appearance of a winner.

Who could blame Melissa? Granted, medical students were supposedly used to competitions, but how many of them had faced an Olympian before? Naturally, she asked herself, Is Kate also interested in psychiatry? If so, my own chance of getting into the program would be in jeopardy.

As the feeling of insecurity grew, a sense of guilt also emerged. Melissa realized how easy it was to be compassionate when she faced a weaker person, such as a patient, but in front of a competitor, a strong one, all that left in her was fear—fear of losing the residency slot that she had hoped for.

To cover her awkwardness, Melissa smiled at Kate and said, “Hi, you must be Kate. I’ve heard of you. I’m Melissa.”

Kate replied with a wide smile showing flashy white teeth, “Yes, I’m Kate. Nice to meet you, Melissa. It’s time to meet Dr. Thomas, so let’s talk later.” She knocked on the door, pushed it open, and led the way in.

Once they entered the office, Dr. Thomas stood up and welcomed them. After a brief introduction, Dr. Thomas sat in an armchair behind an L-shaped mahogany desk. One side of the L shape was against the wall on his left side and the other side faced the door. The students sat by the wall on his right side between his desk and the door. They could see that his desk was very clean and shiny; there wasn’t any dust visible even under the fluorescent lights or piles of folders or papers on the desk. On the left side of the desk was a built-in bookshelf against the wall, and textbooks and magazine binders neatly lined up on each tier. On the wall opposite the students, rows of framed diplomas, board certificates, and award plaques hung in a meticulously arranged up-side down trapezoid shape. But don’t be fooled by this formal or even solemn appearance yet, Melissa thought. Just look at the two family pictures on the bookshelf facing the students: one photo of the doctor and his wife with their heads leaning slightly toward each other, and the other of two boys, both smiling, one with missing teeth–maybe five, and the other perhaps a couple years older. What a happy family! One had to agree that family photos usually add a warm human touch to the ambiance.

Dr. Thomas,  a man in his mid-forties, had carefully groomed dark hair and a long and clean-shaven face. He was tall and slim and dressed in a perfectly pressed navy-blue suit with a color-coordinated silk tie. Melissa noticed that his most striking features were his small, dark, piercing eyes, like those of Hercule Poirot’s.

Trying to shake off her uneasiness, Melissa sat up straight, placing her hands on her lap, fingers laced.

Kate sat with her arms folded, legs crossed, with one foot dangling in the air. She glanced at the family pictures on the bookshelf and said warmly, “Your boys look so cute.”

Hearing her comment, Melissa felt uncomfortable since she wasn’t used to being personal on the first encounter with people, let alone in the chief’s office in a professional setting. She glimpsed Dr. Thomas who appeared happy. Rubbing his hands together, he nodded at Kate in appreciation.

Kate smiled back and added, “Your wife is pretty, and she looks very young.”

Kate’s “friendly” demeanor put Melissa on edge. She thought, Is Kate just a talkative person or is she trying to please him?

Fortunately, Dr. Thomas didn’t seem to have heard Kate’s last comment about his wife. He said to them, “I apologize. We have a new request to see Mr. Miller. Please give me a moment to get some information about him.” Then, he turned to the computer screen and read.

The quiet waiting was a relief for Melissa.

After a minute or so, Dr. Thomas stood up and said, “I’m sorry to rush you. I would like to see him now before my meetings later this morning. Would you care to join me?”

*

Melissa and Kate said of course and then followed him. On their way, Dr. Thomas told  them about Mr. Miller. The patient was eighty-five years old and had knee surgery the past week, had done well in therapy until two days ago, but for some reason he refused to participate in his treatments.

By the time Dr. Thomas finished talking, they had arrived at the patient’s room, and Mr. Miller was in the washroom. While they waited outside, Dr. Thomas took the opportunity to chat with the students. He turned to Kate first and asked what made her choose to rotate in Psychiatry.

Kate replied, “I was an athlete before and I’ve always wanted to know why people do what they do, even if it means taking risks or enduring pain.”

Dr. Thomas said, “Indeed, I’ve often asked the same questions.”

Melissa peeked at Kate and saw a we think alike smile on her face. She took a slow, deep breath and tried to appear indifferent although she felt insecure and suspicious.

 The doctor continued. “Everything has risks. Some people are willing to go to the moon, others are afraid of biking or swimming. Isn’t that interesting? Regarding pain: what is pain? Since pain isn’t measurable, or palpable, how do we know about it? In the case of athletes, you not only endure but also overcome pain, both physical and mental. I don’t think the level of adrenaline is the only explanation for that, especially, as you well know, enduring pain doesn’t guarantee success.”

“That’s very true. There is only one gold medal in an Olympic race, so most of us have to face failure,” Kate said.

Dr. Thomas asked, “So, why do you think athletes do what they do?”

Kate said without a blink, “The desire and the hope to win.”

“Yes, it’s the burning desire, even when the hope is slim,” the doctor said, his piercing eyes narrowed.

Under his pensive gaze, Kate started to fix one of her earrings, and with her large, knuckled, rower’s hands, she lost patience and decided to remove them. Suddenly, one earring slipped out of her hand and fell to the ground next to Dr. Thomas’ feet. He bent down and picked it up. Without looking at it, he handed it back to Kate. Eyes beaming, Kate said, “Thank you.” Melissa watched the scene as if it were a slow-motion clip: the earring, a drop of deep orange amber, slipping from his hand to hers. Her stomach churned and her face warmed. Did Kate drop her earring on purpose?

Melissa wanted to join the conversation, but before she could think of something, a nurse opened the door and informed them that Mr. Miller was ready. Dr. Thomas said, “Let’s talk to the patient first and we can continue our discussion at a later time.”  Melissa and Kate agreed and followed him into the room. Dr. Thomas greeted the patient and explained to him the purpose of their visit. Then he asked him why he didn’t want to work with his therapists.

Mr. Miller sighed and said in a quivering voice, “Today is the saddest day of my life.”

“Why?” Dr. Thomas asked. He stepped closer to the patient and bent down to give him his full attention.

“My wife is going to the nursing home today. We’ve been married for fifty-five years.” He dropped his head on his chest.

“Mr. Miller, your wife would like you to get better so that you can visit her,” Kate said, making a fist in front of her chest with a you can do it gesture.

Shaking his head, the patient said to Kate, “Doctor, you don’t understand. We’ve never been separated before.”

Melissa fought back tears as she listened to Mr. Miller.

Mr. Miller said, “If only I could take care of her at home, or at least be with her today when she . . . she leaves . . . to the nursing home.” Two teardrops rolled down his wrinkled cheeks.

Dr. Thomas pulled a chair next to the patient and sat down. This simple gesture moved the patient. He hadn’t seen many doctors who would take their time to sit at his level, to look into his eyes and talk to him; most just rushed in and out.

Dr. Thomas waited, then said gently, “Mr. Miller, I understand, it must be hard for you, especially when you’re trying to recover from major surgery.” He watched the patient’s face while he talked as if he were reading his mind. After pausing for a moment, he asked him where he and his wife met, where they were married, and how many children or grandchildren they had.

When he heard that Mr. Miller had ten grandkids, he raised his eyebrows and said with admiration, “Ten grandkids? What a blessing!”

Let’s face it, how many men could resist such a compliment? Not to mention that it’s coming from his doctor. The patient’s frown disappeared. He then said, “Yes, I know that. I’ve been truly blessed.” He continued to tell his doctor that two of his grandkids were in the Army and three were in college. Embarrassed, he added, “I can’t even remember all of their names.”

“That’s quite common, Mr. Miller. Not many people can remember all their grandchildren’s names, ages, or birthdays, especially when you have ten of them,” Dr. Thomas said, then patted him on his shoulder.

The old man nodded. Even blessings have their downsides.

Seeing the patient calmed down, Dr. Thomas said, “Mr. Miller, you just had surgery, so it’s normal that you feel weak. Plus, you’re in an unfamiliar environment and take additional medications, such as pain pills. All these factors can negatively affect your mood, sleep and appetite.”

The patient nodded, “Yeah. I know.”

“It’s not easy to cope with all of these at once. But the positive side is that you were healthy before the surgery, so I believe that you will get better gradually. It just takes time and that’s expected. I want to assure you that we’re here to support you.”

Mr. Miller looked at Dr. Thomas. From his gaze, Melissa saw the connection between the patient and Dr. Thomas. This doctor sits right next to me, and his words sound sincere. What else do I need? Just someone, especially my doctor’s understanding is enough.

Melissa observed Dr. Thomas’s down-to-earth bedside manner, his gentle and personal approach, and his unassuming and non-preaching style. Just like what I’ve heard about him, she thought. He truly has given his full attention to his patient. The simple act of sitting down, taking the time, talking and listening to a patient draws their relationship closer. Melissa had seen too many times doctors spending only a few minutes at patients’ bedside. She remembered the title of a famous short story, “A Good Man is Hard to Find.” And a good doctor is hard to find too, she thought. If I could work with him for the next few years, I can learn a lot. But what if they would choose Kate instead of me?

When the interview with Mr. Miller was over, they went outside, and Dr. Thomas wanted to hear the students’ thoughts. “What do you think about this patient? How can we help?”

Before Melissa replied, Kate said decisively, “It’s a typical case of adjustment disorder. It seems pretty serious. Time is the essence. I think we should start trazadone right away.”

Dr. Thomas turned to Melissa and asked her what she thought. Without hesitation Melissa said, “I agree with what you said earlier, Dr. Thomas. It’s hard enough to deal with post-surgical recovery at his age. Now, this separation is even more devastating. I doubt the medication alone would be enough. I think we should also ask a psychologist to see him.”

Dr. Thomas gave Melissa a nod of approval and said, “You’re right. It isn’t an easy adjustment at his age and in this circumstance. I can see why he feels powerless and hopeless. one feeds into another. I agree with you. Let’s ask a psychologist to give him extra support. And don’t forget to consult Social Worker Service to provide more assistance for him once he goes home.” He turned to Kate again and added, “Yes, we can start a low dose of trazadone to boost his mood and appetite and help him sleep.”

The mention of trazodone’s benefits pleased Kate. She waved her hand with three fingers up in the air and said triumphantly, “Kill three birds with one stone.”

Ordinarily, this kind of exchange wouldn’t bother Melissa. She would have just laughed at it. But today, the first day of her critical rotation, every word or gesture seemed to have special meaning. Kate’s spontaneity and quick wit, although natural, appeared to be a warning to Melissa: An invisible race has begun whether she likes it or not.

*

On Monday of the fourth, the last week of their rotation in Psychiatry, Kate asked Melissa to have lunch in the hospital courtyard. Usually, at lunchtime, Melissa sat in the hospital cafeteria in the corner, always in the same place as if it were reserved for her. She would read and eat her homemade peanut butter sandwich by herself. But today, upon Kate’s invitation out of the blue, an irresistible curiosity seized her. So far, she had survived this unusually long rotation under constant pressure to prove herself yet, she asked herself, Why does Kate want to talk to me at this crucial moment? Does she know something that I don’t?

With a prying mind, Melissa said, “Sure.”

She followed Kate to the courtyard and found a bench in the corner where nobody could hear them. After small talk about the nice weather, Kate began, “I met one of Dr. Thomas’s patients yesterday,”

“Er-hum?” Melissa waited. As part of the training, each medical student saw only one patient during a half-day clinic with the patient’s consent. In this way, the students had ample time to learn about the patient’s medical history and current conditions. At the end of each week, they got together to discuss the cases with their mentors.

Kate continued, “She’s good looking and chic, and she wore a Ralph Lauren outfit and an exquisite pearl necklace with matching earrings.”

Melissa noticed Kate’s eyebrows raised at the words, “chic” and “exquisite.” Her description of the patient reminded Melissa of a magazine cover that she saw at a beauty salon. An attractive patient, she agreed.

“She’s been seeing Dr. Thomas for fifteen years.”

“That’s not unusual. Most mental health patients have chronic conditions.”

“But she complains about numbness on her face.”

 “Numbness? Shouldn’t she see a neurologist?” Melissa asked.

“That’s why I’m telling you,” Kate said.

Still unimpressed, Melissa said with a detective’s instinct, “I’m sure she has a reason to see Dr. Thomas.”

“According to her, her numbness is stress-related.”

“That makes sense.”

“She said that she and his wife were rivals before his marriage.”

“Hmm. Really?” Melissa turned to Kate and fixed her eyes on Kate.

Melissa could tell that Kate had finally captured her attention and was elated, as if knowing something that others don’t was a currency of high value. Then she said with a more convincing tone, “You must admit, Dr. Thomas is handsome and charming. Naturally, some women would have a crush on him.”

“That’s true,” Melissa said, and she thought of  Kate’s earring-dropping scene. “Do you have a crush on him, too?”

Kate didn’t seem offended by her question. She said matter-of-factly, “No. But the reason I’m telling you is that it’s not only dishonest of him to have an affair with her, but it’s also against the hospital protocol to date a patient.”

“I know that. But are you sure that she’s telling the truth? I’m not saying that she lied intentionally. People’s memories about the past could be and often are distorted.”

“It’s obvious that she’s in love with him. Otherwise, why has she seen him for so many years?” Looking at Melissa’s doubtful expression, Kate continued, “I can see you don’t believe me. Don’t think I’m a righteous person, far from it. All I want to say is that if he seriously wants to date her, he should ask her to change to a different doctor for his own sake.”

“Isn’t that proof that he’s not interested in her?” Melissa shook her head.

“Not interested? Let me tell you, men are alike. You’re young, and excuse me for using the word green, but I’m much older than you guys and doubt you’ve even worked anywhere before.” Kate sighed. “Let me tell you, one can be easily deceived by family pictures in the office or at home. That’s a show of a so-called ‘happy family’.” Kate rolled her eyes with an air of déjà vu. “I’ve seen too many people, especially men with power, take advantage of women. You don’t know what they do behind the family’s back.”

Melissa sensed Kate’s condescending tone. Although she appreciated Kate’s intention of not wanting her to fall into the trap, in this particular case, she needed more evidence. After all, she had to satisfy her detective mind. Furthermore, she was intrigued by Kate’s sensitivity or perhaps resentment to her patient’s attractiveness and by Dr. Thomas’ office pictures. Do any of these remind her of her past experiences? Was she cheated before?

Melissa felt as if they were at a museum, looking at the same still-life painting by Cezanne. She saw the fruits as bright yellow, orange, and green, whereas Kate perceived gloomier brown, purple, and blue ones. This isn’t an illusion, or a delusion, Melissa thought, but a viewer’s past can mold or even alter one’s perception of a piece of art. Who can tell the true meaning of the paintings by Van Gogh, Vermeer, Frida Kahlo, and many others? No one. It all depends on the mind, which is tricked by the past and the moment. Melissa sank into even deeper thought.

Watching Melissa stare into space, Kate asked impatiently, “Do you see what I mean?”

Melissa shook her head and said, “I’m sorry. I was thinking. I understand what you’re trying to tell me. It’s complicated. As far as I’ve seen, it’s common, or maybe a tradition, or a habit, for people to hang pictures in their office or at homes. I take it as a marital statement, just like people wear a ring on their ring finger. That’s all. But the pictures reflect a fixed moment in time only. As time goes on, people naturally change, for good or bad.”

“Exactly,” Kate agreed.

“Regarding your patient, even if she had some sort of romantic relationship with him before, that was fifteen years ago, and it’s over now. She should let go of the past.”

“She can’t. Not everybody can. I’ve seen people holding on to their feelings for a long time,” Kate said.

“That’s why it’s pathetic. You’ve heard people say what cannot be cured, must be endured.”

Kate said, “Yes. I can only relate to athletes. We endure pain, stress, and even injuries because there is hope, the hope of winning a medal.”

“Your patient has endured for fifteen years, so it’s obvious that she has no more hope.”

“Well,” Kate gave Melissa a believe-it-or-not look and said, “she told me that Dr. Thomas’s wife is sick.”

“Sick?” Melissa frowned in disbelief.

“Apparently, she has ovarian cancer, stage IV. You know that this is a common cancer in women of her age,” Kate said.

 “I’m very sorry to hear that,” Melissa said. Then, all of a sudden, as if there were a lightbulb moment, she realized, Is this why Kate’s patient was so eager to talk? Did she see the light at the end of the tunnel?

Melissa saw a baffled expression on Kate’s face. Does she feel hopeful for one and hopeless for the other? And strangely, Melissa felt sympathy toward both the wife and the patient too, which drew her closer to Kate.

“Hey, don’t tell anyone that I told you this. I don’t want people to think that I like to spread rumors,” Kate said.

“I won’t. But you don’t care about his violation of doctor-patient protocol anymore?”

“I’m not one hundred percent certain what has happened. It’s a one-sided story anyway. But I have my sixth sense. Since I’m older than you, I want to warn you not to be naïve. That’s all.”

“Thanks. I appreciate it,” Melissa said with increased respect for her seniority.

After lunch, they went to their separate clinics, but on her way, Melissa thought, Maybe Kate is no longer interested in this program. Maybe her past experience made her suspicious of people, including Dr. Thomas? But I can’t compare myself with her. Kate has everything: her appearance, her eloquence, and her passion-driven and outgoing personality. With her Olympic experience stamped on her resume, she can be choosy and would be an asset to any residency program. What do I have? Nothing worth mentioning; I don’t have even the name of an Ivy league attached to my resume. The silver-lining: If Kate withdraws, I may have a better chance to be accepted here. Is this fate again?

*

Feeling a bit more optimistic, Melissa walked faster. She passed two corridors and arrived at the hospital chapel. The chapel was a large room with no more than four rows of benches on each side. Since Melissa still had time before her clinic, she went in. Standing in front of the altar, she saw three rows of candles on a rectangular table, and about one third of them were lighted. The shimmering flames blurred her vision: Is this a hope or a trap for me? Am I making the right decision? She lit one candle carefully, knelt on the footstool, and pressed her palms together. She murmured, “God, please help me.”

After a few minutes, Melissa stood up and walked toward the exit. As she turned to leave, a man in a white coat walked by and she almost bumped into him. She raised her head and saw Dr. Thomas. “Oh, I’m so sorry.”

“Hi, Melissa.”

“Hi.”

“You visited the chapel?” Dr. Thomas asked.

“I…I was praying for…someone that you know.”

“Someone I know? A patient?”

“No, I heard that your wife is sick.”

“Who told you that? As a matter of fact, we are expecting a baby next month. That’s why I switched my clinical schedule with my colleagues. As far I know, she’s doing well.”

“A baby? Congratulations. But Kate said your patient told her…” Melissa’s face turned red.

“My patient?” Dr. Thomas touched his chin with his fingers.

“Hmm… the one with facial numbness.”

“Ah, I know who.” Suddenly his pager buzzed. He looked at it and said, “Anyway, it’s time for your clinic now. You should go. By the way, since this is the last week of your rotation with us, do you mind coming to my office the second Monday in March at noon? We’ll talk about this case in more detail.”

“Of course, I will,” Melissa said, feeling relieved that his wife was well.

Dr. Thomas waved goodbye and hurried away.

On the second Monday in March, Melissa went to Dr. Thomas’s office at lunchtime and noticed that Kate wasn’t there. Knowing that the result of her application could be announced at any moment now, she felt excited.

She saw the office door was ajar, so she knocked lightly. She could hear her own pulse in her eardrums.

“Come in,” Dr. Thomas said.

Melissa took a deep breath and pushed the door open. The moment she stepped inside, Dr. Thomas stood up and said warmly, “Congratulations!”

Melissa was startled, but she knew that it must be good news.

“Melissa, you’ve been accepted into our program. I discussed your attributes with the other doctors in the department last month, and everyone thinks you will fit in very well.  They especially like that you are a good listener, which is the single most important trait that a  psychiatrist must have.”

“Thank you very much,” she said. Still surprised, she confessed, “Honestly, I thought Kate had a better chance.”

Dr. Thomas said, “Kate is a strong candidate. She’s a goal-oriented and decisive person. She told me last week that her first choice is orthopedics, and she would like to specialize in sports medicine in the future.”

“Wow, that’s perfect for her,” Melissa said with a mixed feeling of relief and admiration.

Dr. Thomas changed topics. “Compared to orthopedics and other specialty physicians, we, the psychiatrists, have to listen and ask why. We must take off the healer’s hat. This doesn’t mean we lower ourselves, but simply to be a human being and have a human-to-human relationship with patients. This is why listening is so important in comprehending patients and distinguishing their dreams from realities.”

 Grasping each word, Melissa asked, “I’m sorry to interrupt you. I wonder if it is possible that your patient told Kate about her dreams?”

“You’ll see more patients like that. Oftentimes, patients aren’t aware of the facts.”

“But do you think for some patients, dreams are realities or even hope?” Melissa inquired.

“Yes. For many people, I mean even for normal people, dreams are realities. Depending on the dreams, they can be about hope or despair or many other things.”

“Many other things?”

“Yes. I don’t know if you like to go to museums, but let’s take still-life paintings as an example. Do such paintings represent realities, or illusions, or simply desires? In the real world, living things don’t last forever. Do you find the words “still” and “life” contradictory or complimentary?”

“It’s hard to say. In medicine, when we say a stillborn, it would mean the opposite,” she reasoned.

“That’s why the mind is tricky. There isn’t a measurement that can tell us what’s normal or abnormal. We can’t use the mentality of measuring blood pressure to measure the mind.”

She nodded agreeably.

“Our specialty is the study of the mind, unlike for the heart, stomach, or brain, where doctors can visualize diseased states with today’s technology. In psychiatry, we still can’t.” He pointed to his tie and asked, “You see this color?”

“Yes, blue.”

“What we see is the reflected color. It means blue is the color that isn’t absorbed. In our field, it’s the absorbed or the invisible colors that we seek to understand.”

Her face warmed again. “I’ve forgotten all my high school physics.”

“We’re all the same and can see only the surface.”

“It’s hard to see something beneath it,” Melissa admitted.

Dr. Thomas nodded in acknowledgement. “Yes. It’s easier to make a quick judgement than to truly understand the raison d’etre. You see, psychiatry isn’t and can’t be a race for medals. We can’t promise a rose garden either. There isn’t a clear finish line in our field. It’s a process, a long process, that might take years or even decades.”

She weighed his words and thought about Kate’s patient.

“It requires a different kind of passion. A passion to understand, rather than to conquer,” Dr. Thomas added.

“But how to tell a passion from an obsession?” Melissa asked inquisitively.

Dr. Thomas was pleased to hear this question. He hadn’t seen many students think as deeply and quickly. He said, “I can see you already think like a psychiatrist. That’s very good. In our field, it’s more important to ask a question than to answer one. And your question is a hard one. I don’t pretend to know the answer. As a matter of fact, there isn’t an answer to that question in a dictionary. The answer exists in real life only. And again, for different people, at different times, the answer is different.”

Melissa listened, reflecting on his words. How interesting! she thought. Thank God, I didn’t withdraw my application from this program. Now, I’ll have a chance to work with him for the next few years.

Melissa pictured a long road ahead of her, an endless one, or a road with an unperceivable end. But this road of psychiatry is her choice, the right road for her. After all, the old English root of the word road is rode or rade, meaning to ride, or journey. Melissa knew that she would enjoy this journey. It is her destiny.

That afternoon, for the first time since the beginning of her clinical rotations, Melissa couldn’t wait to go home to call her parents.

About the Author

Quin Yen

Quin Yen resides in California. She enjoys reading, writing and hiking. Her stories have been published in the Brilliant Flash Fiction, The Write Launch, and the Rollick Magazine.

Read more work by Quin Yen .