Enjoy Your Life with Colleen Farrell, MD
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What does the opening disclaimer say about patient privacy and speaker views?
At the Nocturinous, we are careful to ensure that all stories comply with healthcare privacy laws. Details may have been changed to ensure patient confidentiality. All views expressed are those of the person speaking and not their employer.
Practicing medicine means exposure to mortality early and often. Sometimes we're right there with our patients when they get a new devastating diagnosis. And this can bring up our own fears of illness and mortality. Because while death is inevitable, being at peace with it is not. I'm Emily Silverman and this is The Nocturnous, stories from the world of medicine. In this episode, internal medicine resident and founder of Twitter's Med Hume chat, Colleen Farrell, comes to grips with a young woman's new brain cancer diagnosis. New to medicine, Colleen feels unprepared to handle this news. And in the conversation that follows, she and I muse about the lifelong task of coming to terms with our own mortality.
But first, here is Colleen Farrell.
It's the end of summer and I'm working in the emergency department. I've just finished my first two years of medical school, which means I've been learning medicine from textbooks, but the hospital is totally new to me and I have no idea really how it works. I meet a patient that night who I'm going to call Ellen.
How does Colleen describe her first encounter with a patient diagnosed with a brain tumor?
She tells me that she's been having some double vision and nausea for a few months. I notice on her physical exam that When she looks to the side, her eyes wiggle back and forth in this way that's definitely not normal. And so we decide to get an MRI of her head. And on the MRI we see a big mass inside her skull. We talk with radiologists and neurologists and surgeons and Everybody agrees that Ellen has a malignant, inoperable brain tumor. Growing up, I knew this kid named Billy. When we were about ten, Billy was diagnosed with brain cancer. I can still picture him in the gym of our elementary school playing basketball with this enormous scar on the side of his head. Each one of our classes in my school made a quilt square for him and we put them together into a blanket that we sent him home with.
You Are My Sunshine is the song that they played at his funeral. My mom says I was really curious about death growing up, that I asked all kinds of questions about it. What I remember is that I thought a lot about Billy. I used to picture him laying in bed surrounded by his family members. And I would wonder what was going on inside his head. What is it like to know that you're going to die? What do you think about? And it was in thinking about Billy that I had my first inclination that I wanted to become a doctor. What's kind of interesting to me looking back is that I didn't have This hope of becoming the heroic surgeon who would cut open his brain or remove the cancer and save his life. I think I just wanted to be with him and
And be able to provide some kind of comfort. While having those scary thoughts about death. Ellen was admitted to the hospital for a few days for further tests and to be seen by more specialists. As the medical student on her team, I would see her really early in the morning and I'd wake her up and I'd say, Oh, I'm so sorry to bother you. And I would make sure that she'd been getting enough medication for her nausea and that she wasn't in pain. But I never really talk to her about What was happening about this diagnosis that she had received? So one day I'm leaving the hospital and I have my backpack on and I'm walking towards the elevators and I walk past Ellen's room. Somehow seeing her room I I remember that
It's the day that she's supposed to be discharged from the hospital. She's going to go home with her husband. And so If I want to talk with her, like really talk with her. Now is my chance. As soon as I think of having a real conversation with Ellen, my stomach is in a knot and I think about all the ways it could go wrong. Like, does she really want to talk to the medical student?
Why does Colleen recall the story of her classmate Billy and how did it shape her view of death?
And and what if I say something that just makes it worse or or makes her upset? And and so I I go through this whole line of thinking and convince myself that maybe I should just go to the elevator and and go home.
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Chapters
8 chapters
1
What does the opening disclaimer say about patient privacy and speaker views?
0:00–1:26
2
How does Colleen describe her first encounter with a patient diagnosed with a brain tumor?
1:26–4:14
3
Why does Colleen recall the story of her classmate Billy and how did it shape her view of death?
4:14–8:34
4
What emotions and thoughts did Colleen experience when she finally spoke with Ellen in the hospital?
8:34–12:39
5
How did seeing Ellen in a coffee shop change Colleen’s understanding of dying versus being dead?
12:39–16:26
6
What insights does Colleen share about teaching empathy and confronting mortality in medical training?
16:26–20:03
7
How did the Med Hume Chat originate and what purpose does it serve for physicians?
20:03–24:59
8
What final reflections and calls to action does the episode end with for listeners and supporters?
24:59–33:20