In medical settings, people generally assume that I’m very young and that I have little personal life experience. Maybe it’s my baby face. Maybe it’s the fact that medical training is so time-consuming that often doctors don’t pursue a personal life outside of their career until they are older. Maybe it’s the fact that we devalue individual experiences, knowing that “an n of one” should not drive decisions. Or, maybe it’s the fact that our work conditions are so frequently inhumane, and the work itself is often dehumanizing (of course, those characteristics aren’t unique to medicine).

At any rate, my significant personal life has always come as a welcome surprise to patients and a bit of a curiosity to older physicians. That my personal life could include hardship and sadness — the possibility doesn’t cross anyone’s mind. I don’t intend to shock people, but my experience is shocking. Keeping quiet about the experience makes me feel sad and stifled, as though my atypical hardship were shameful, when nothing could be further from the truth. Medicine failed my child and me, not the other way around.

I’m still not sure where my story belongs. Or where I belong. So I’m having lots of conversations like the following.

Kindly Hospice Attending (initiating an educational conversation with me while he completed a death note for a patient who had just passed): “How do you diagnose death?”

Good Resident Kaitlyn: “Well, it depends on the case…

I would call in help for an unanticipated death or especially to determine when to end resuscitation. Or for brain death. But generally, if there are no heart sounds or breath sounds after listening continuously for sixty seconds, then death can be diagnosed.”

Attending: “Right, sixty seconds. I think breath sounds are more useful than heart sounds, because the heart sounds can be very faint and it’s hard to know exactly when they stop. The breath sounds usually are more distinct, and waiting sixty seconds is important because a patient may be apneic for forty-five seconds, then take a breath again, so you keep monitoring even if there are no heart sounds.”

Me: “Right, it can happen the other way though, too. Sometimes the heart is beating without any noticeable breathing.”

Attending: “Hmm, I don’t usually see that.”

Me: “When my son died, he had heart sounds for about two hours after his breaths stopped.”

Attending: (pained, staring, wordless)

Me (desperately trying to re-shape my story so it will fit into the frame of medical knowledge): “Well… maybe it’s because he was a baby. Maybe infants are different.”

Attending: “Oh my gosh. Your baby died.”

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