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We provide you with articles on brain science, timely topics, and healthy living for those affected by neurologic challenges or seeking better brain health.  

Speak Up
By Puja Shankar

Inside Out

After a doctor becomes a patient, she develops a much deeper understanding of what her patients go through.

I need to be admitted. I think I have Guillain-Barre syndrome," I said shakily to the receptionist at the emergency department. This was the same department I'd rotated in just a month earlier. She looked at me quizzically until I showed her my employee badge with the bold letters "MD" next to my name. Her expression changed from confusion to concern.

Illustration of woman getting IV
Illustration by Avalon Nuovo

Within minutes I was on a stretcher, wincing as an intravenous line pierced the soft skin of my forearm and began filling tubes with my blood. The pale pink electrocardiogram showed a heart rate most people have during strenuous exercise. To tamp down my fear and panic, I focused on the flustered intern who repeated his questions twice before diligently writing down my answers.

My words sounded foreign to me, clumsily relating a story that even I was having trouble believing. For days I had awakened to a racing heart, so fast its beats were indistinguishable. A disturbing fatigue would set in that left me breathless after menial tasks. But the symptom that sent me to the hospital was a persistent, pervasive tingling and numbness that started in my toes and eventually rose to my neck. I had tried to diagnose myself and treat my symptoms at home, until my rationalizations began to sound hollow.

Now, in the emergency department, doctors huddled around me and spoke in hushed tones, their expressions hidden behind pandemic-mandated masks. Words familiar from textbooks were suddenly a possible reality—Guillain-Barre syndrome or perhaps multiple sclerosis, pulmonary embolism, or coronavirus. A blur of tests followed: a loud MRI scanner that sliced hundreds of frames of imaging from my brain and spinal cord; a CT scan with contrast dye that burned my insides; a lumbar puncture; and innumerable blood draws.

Gradually the tests and imaging began to coalesce and show results: I was diagnosed with acute inflammatory demyelinating polyradiculoneuropathy (also known as Guillain-Barre syndrome) and was treated with intravenous immunoglobulins. Following the diagnosis, I couldn't shake a profound sense of betrayal; my body was producing antibodies against my own nervous system.

During my hospital stay, I barely slept and felt constant vibrations in my limbs and an eerie sensation that the bed was moving under me. I developed a strange sort of seasickness, holding on to the rails of my bed and having to catch my breath often. The transformation from physician to patient was disorienting. For years I had been the one standing at patients' bedsides, speaking with calm, reassuring confidence. Now I had become the quiet, nervous patient whose words died in her throat, who expressed childlike vulnerability as she looked up—not in wonder or awe, but in fear.

After a week, as I was getting ready to leave the hospital, I began to worry. No longer would anyone be constantly monitoring me and tending to my every need. The concern and care from others seemed fragile, impermanent. I appreciated them, but I feared they would fade. At the end of the day it was just the two of us, my illness and me.

During residency, I've wondered what happened to patients after discharge. Were they okay after we sent them home? My musings were always short-lived, vanishing when a new patient arrived. As a physician, I liked to consolidate my diagnoses into neat packages of medications, orders, and recommendations. But guidelines and protocols cease as soon as patients are out of the hospital and alone in their own beds, filled with the trauma they've endured.

In the months since my diagnosis, I've come to understand the winding aftermath of a serious illness. I still deal with tingling and numbness in my legs and an elevated heart rate, which is controlled with medication. As I navigate my new reality, I marvel at my patients' ability to find strength in the face of a formidable unknown. I used to try to project confidence and reassurance. Now I hope to show concern and compassion. I want to nurture my patients as the human beings they are beneath the diagnosis and make sure they know that I'm there for them whenever they need me.

Puja Shankar, MD, is a second-year anesthesiology resident at Beth Israel Deaconess Medical Center in Boston. In her free time, she is an avid reader and enjoys cooking and boxing.