“Do you possess a key?” my grandmother inquires. I pause, and she reiterates, “Do you have a key to this location?” She sits in a hospital chair behind one of those hospital tables adorned with a tray full of hospital cuisine in front of her. She is nearly skin and bones; her shirt and pajama bottoms hang loosely on her frame. My mother is on the bed, gazing at me.
“Yes, certainly,” I reply. My grandmother nods in approval and relaxes a bit, as does my mom. It’s fascinating how swiftly deceit transforms into the right choice. I examine her face; tiny dark hairs emerge from her chin that I had never noticed before. Her usually impeccably groomed hair is fluffy and slightly knotted.
My father always joked about how dementia runs in our bloodline, “One day, you’ll be changing my diapers!” I’ve never found this amusing. The thought of my parents growing old unsettles me; I actively steer clear of these anxiety-inducing ideas. But for my grandma, it was no joke and not something she shunned. She had a living will, a do not resuscitate directive, and no supplemental nutrition permitted in her end-of-life plan. Despite her clear desires for her final days, my family couldn’t help but strive to prolong them.
Though we disagree on many topics, my family was united in getting my grandmother to eat. Four days prior, my three siblings and I gathered in the kitchen for an impromptu brainstorming session. My mother, a personal trainer who maintained a strict ingredients-only household, proposed more ideas than anyone. “Is cake out of the question?” someone queried. “It might be overly sweet,” another person remarked. We ultimately settled on a milkshake: the ultimate blend of easy to consume and delicious.
Two days ago, my sister whipped up a milkshake with rocky road ice cream to bring to my grandma. Two days ago, my grandma relished the milkshake. She enthusiastically nodded and finished it completely. Today, she is repulsed by it. She takes a single sip and promptly shakes her head, wrinkling her nose with pursed lips. She pushes the milkshake away from her. I can’t fault her for her disinterest in eating. The aroma of a hospital is hardly appetizing. I glance at my sister. She is unnaturally still, struggling to maintain a neutral visage, but her eyes start to shine. I discreetly reach out to hold her hand. My mom comforts my grandma, assuring her that it’s alright, and nudges the hospital juice in front of her.
Even though my grandmother isn’t acting like herself, she is the only honest person in this hospital room. I am feigning possession of a key to the hospital, my sister is pretending not to weep, and my mom is pretending that everyone is fine.
This occurred nearly four years ago, and I am now beginning my fourth year of medical school. My training has encompassed many things; however, one element I did not foresee was how beneficial “pretending” has proven to be. Pretending to be alright, pretending to absorb everything, pretending to be an older woman experiencing chest pain, and then pretending to be the physician attending to her. A part of medicine is pretending and role-playing until suddenly it’s not. You perceive the melodic quality of a wheeze for the first time and mistakenly think someone’s phone is ringing.
Perhaps pretending is merely another term for practice, and I am grateful for this chance to practice medicine.
Paige S. Whitman is a medical student.