Perspective
Healing Camilla’s Heart
It takes a preceptor’s fearless self-disclosure to convince a medical student to accept herself.
By Rachel Hammer
Camilla and I take turns threatening to quit medical school. It all started the first week when the sheen of pride at having made it there turned to sweat as I realized that as a doctor I could, and probably would, kill someone with my stupidity. Camilla had the same fear and promptly decided she would become a medical examiner because in an autopsy the person is already dead, the harm already done. I then wanted to quit when I grew existentially skeptical about whether healing was real in this broken world; and, besides, it seemed harder and harder to balance being a doctor with my dream of starring in musicals and writing the great American novel. Then Camilla relapsed into doubt, worrying that she wasted too much time learning fancy medical jargon, that she had neglected her friends and family members, and that this whole doctor thing was becoming a quest for a selfish trophy rather than a vocation of service. Then it was angst over the evils of health insurance. Then “medicine as a business” and reconciling with the fact that we would one day profit from illness. Then the disparities in health care. Then god-awful telemedicine. And then the whole matter, the futility, of actually learning everything. But we do learn. Inhaling the same narcotic idealism that floated us toward the vocation, we still believe we will be good doctors who will work for free, and being the brave academic warriors that we are, we keep chickening out of chickening out. Each morning, Camilla and I are pleasantly surprised to see the other still taking notes and tests, as though our brains and good grades will save someone—ourselves for the time being.
Camilla caught up with me the other day on our way to an afternoon liturgy of basic science. As usual, she made me laugh long and hard. My mother says she is “the doctor with a big heart and kind eyes.” Next to the other resume- twitterpated doctor proteges, Camilla is a pocket of warm air. “I really love these interludes of ours, Camilla,” I said, noticing that I live for the interludes. But to call them “inter” is disingenuous because they are not breaks between important things. How could managing emails, the zombification of studying or working—God, the interminable working—be the important things? When we are dying, are we going to wish we had spent more time with our computers? The main events in life are these ludes, the sunbursts when we are so thick in the clouds we just might cry, the flush of contentment after having just enough wine and good company, saying exactly what you mean and being heard.
One day at lunch, Camilla said she needed to talk. In her eyes was a look like I had mistakenly taken a cyanide pill instead of my multivitamin. Red alert. A week later, our eyes were red from crying after we had looked in disbelief at a sinister constellation of white starry tangles in the dark night of her mammogram. The shock of discovering that lump rippled through the background static of the season even after it had been savagely plucked and smeared through a pathologist’s lens. There was the hole where the assault on youth’s confidence had transpired. The scar on her soft left breast had the benign quiet of a battlefield several days after the fight or Lake Ponchartrain years after Katrina. Never will the land escape its story, and neither will Camilla’s breast. In this way, the body is much more of a narrative than a textbook.
A week after the “elephant in the boob,” as we called it, was gone, we were partners in physical exam class. While practicing my signature doctor move on Camilla, listening to her heart sounds, I moved the stethoscope to where the mitral valve rings clear, right under, or sometimes on, the left breast. But as I was about to settle the diaphragm on skin, my hand caught itself. Face hot, I remembered. And Camilla remembered. She hadn’t told anyone else, not her family, not a single friend but me, and I was sworn to silence. She hadn’t wanted them to worry.
“Is this OK?” I searched her eyes for a green light. Tight-lipped, she looked away.
“OK, honey, I’ll just skip this part.”
But the tears had already come.
Dr. Patrick, the proctoring physician, came up to the exam table where Camilla hid her face, her forearms held defensively like a boxer’s over her bandaged chest. And I told.
Dr. Patrick paused, then picked her words as though placing dominos in a precarious line. “Camilla, it is hard. But you are still beautiful, you know that? You are sweet and sensitive and beautiful.” Camilla sobbed harder. Dr. Patrick straightened her arms against Camilla’s knees, ducked her head in thought, and then knelt beside the table and looked up at Camilla from where her tears splashed.
I stood there helpless and thought for the millionth time that I should quit this whole doctor thing since I seemed prone to sicken the healthy. “OK,” Dr. Patrick said, changing strategy, “This is one of those doctor-becomes-patient moments.”
She asked me to lock the exam room door. When I turned back, Dr. Patrick stood up, unzipped the back of her mini dress with electric orange and pink circles, and peeled the straps from her shoulders.
“You need to see my smiley face; you need to know that you are beautiful with your scars.”
Her bare chest was exposed down to her hip bones. Her breasts had gentle creases where the knife had been; another line curved under her belly button, a smile where her womb slipped through.
“Please look,” she instructed.
Sweet, shy Camilla looked; she admired. The tension in the room eased, and we all breathed with gratitude for a moment. She was beautiful.
Maybe that day, maybe the next day, Camilla rediscovered her own smile, and her kind eyes shone the way they used to. In hers and Dr. Patrick’s storied bodies, I have seen stubborn beauty, the sultriness of survival, and in their powerful acceptance of their scars, evidence that not only the body, but more importantly, the soul can knit.
A new confidence wove through my spirit that day. I know now I’ll never give this up. Although we’ll never be tested on it, I’ve learned that the delicate space between doctor and patient is sacred ground, and it is an honor to share these ludes. The soul needs sturdier fibers than the flesh, so maybe doctors don’t need to know everything; but they must know themselves, they must love themselves, and, tenderly, they must convince their patients to do the same. MM
Rachel Hammer is second year student at Mayo Medical School. She is also the daughter of a breast cancer survivor.