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  • A Family Physician:My Role and My Specialty
  • Ambika Rao

"What lies behind us and what lies before us are tiny matters compared to what lies within us."

This is the quote I wrote in my father's birthday card the year he was diagnosed with cancer. I was a senior in college and was struggling for ways to communicate. I wanted him to know that I truly believed he could beat this disease. However, at the age of 20, I had yet to learn the delicate manner of discussing the emotional upheaval that follows a terminal diagnosis. I wanted to ask him if he was scared, if he was confident, or if his brave and calm demeanor was solely for our sake. I desperately wished to talk to him about this journey. But this was my father, my protector, and I was too frightened to bring up his mortality.

That was when I was 20. Now I am 25, finishing medical school, and find that sometimes I do not have the luxury to not address mortality.

When my father was sick, I was lucky enough to have a sister who was in her 4th year of medical school. That year she called the shots in our family. As my father's health started to decline, she was the one who noticed the initial symptoms of metastasis and rushed him to the hospital. She was the one who recognized dehydration and arranged a home IV fluid drip. She was also the one who was given the burden of listening to the doctor tell us that my father had a 50% chance of dying within two months, and it was up to her to help make decisions about his treatments.

Though I didn't have the medical knowledge at the time to help her make those types of decisions, she relied on me for emotional support, and this defined my role for that year.

My father passed away a year later. Amidst the devastation, I remember feeling a tiny sliver of relief. It was a sense that a weight had been lifted. Suddenly, we were done obsessing over his cell counts, essentially living in a hospital room, and constantly holding our breath waiting for the next complication to arise. I remember thinking that the hardest part was over. As my family and I embarked on the road to recovery, we realized we had become quite adept at having difficult conversations. My father's illness and death had given us a platform to express these vulnerable feelings. We understood that death didn't discriminate between young or old, healthy or sick, and that we weren't the only ones to experience a loss like this. What I didn't realize, however, was how quickly I would have to engage in these conversations with people outside my immediate family.

Anyone who has been to medical school would probably agree that it opens the floodgates for numerous relatives and friends calling to ask your opinion about their medical concerns. Early on, I was able to dodge my hypochondriac kin with the excuse that I had not started my clinical rotations yet and still had much to learn. Soon enough, however, I emerged from behind my mountain of books and notes, and the protective cloak of the library was gone. I now had to don my pristine white coat, albeit a little short, and finally put into practice all that I had learned. The onslaught of health–related inquiries from my family members resurged. Knee deep into my final year of medical school, I felt excited, but also nervous. Just as I strived to have good clinical judgment while on my rotations, I also wanted to ensure I was giving my loved ones the proper guidance they sought.

Sure enough, I was soon put to the test. My family and I were in Texas for a wedding when my [End Page 21] aunt mentioned she was feeling under the weather. Fairly certain this was just the start of a simple upper respiratory infection, I offered to accompany her back to the hotel. After a few hours, I checked on her and saw that she...

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