Matt Breseman is a medical student in the University of Vermont Larner College of Medicine’s class of 2024.
Breseman’s first year of medical school was anything but “normal.” As he started his medical education, Breseman unexpectedly became one of the patients he was training to eventually treat.
This is his story.
The morning before my first medical school exam I woke up in immense pain. As I made my way into the kitchen in search of some cure-all coffee, the fatigue I felt was normal, but the angry red nodules invading my skin and the large patch of necrotic tissue on my thigh were not. An hour later I was in the local clinic being evaluated.
The next day I missed the exam, instead undergoing a double biopsy. My test results came back inconclusive and the uncertainty of my situation was jarring. I originally chose to attend medical school to learn how to help people with their illnesses. Instead, I became sick, putting me in the role of the patient.
I hope that by sharing my journey I can direct attention to the difficulties of being a patient and thank the people that helped me along the way.
“When I was accepted into medical school people warned me it would be tough, but no one warned me how difficult being a patient would be.”Tweet
The Student Becomes the Patient
Early on in my illness a friend sent me a meme.
“How do medical students get sick; can’t they just open a textbook and cure themselves?” it asked.
Although it wasn’t that simple, I learned a lot from the process of trying to discover what was wrong with me.
After hearing about my illness, a professor went above and beyond by reaching out to a friend she thought could help. This physician ended up captaining my care for months and I learned a great deal from her. She explored every possible cause of my illness and took the time to teach me about each exam I underwent—explaining the logic for ordering it so that I always felt informed and involved in my care. I was getting a crash course on the art of medicine from the patient perspective, with my medical bill jokingly serving as the cost of tuition.
As time progressed my illness proceeded to affect major systems of my body. Coincidentally, the first semester of medical school was also roughly structured by body system. Therefore, despite not attending class, when I did take exams, I felt prepared on a personal level.
For example, in the cardiology section I had the structures of the heart reinforced for me by a technician who showed me my own heart anatomy during an echocardiogram. I also received vocabulary lessons. I was let in on the trade secret that the broken blood vessels popping up all over my body are called telangiectasias—a word that would definitely win any scrabble game.
All jokes aside, during these few months my health continued to deteriorate. I became increasingly fatigued, my resting heart rate increased over 30 beats, and with light activity I would often “blackout” and have no recollection of the event. This made monitoring each occurrence quite difficult and completing simple tasks like driving or grocery shopping became dangerous.
Yet, despite everything going on medically, I was enjoying my first few months of school.
Everything took a turn for the worse in November when my grandpa started losing his multi-year battle with cancer.
My grandpa and I had always been super close and watching him fight for his life absolutely broke my heart. With my grandpa dying and my health in shambles, I was beginning to become despondent. As depression and lack of motivation were just starting to close their grasp on me, I received some timely perspective in the form of a lecture by our ethics professor.
While waiting for a blood draw, I listened to a lecture in which our professor discussed the hierarchy of ethical decision making and a physician’s role in end-of-life care; a topic I had been navigating with my family regarding my grandpa’s situation. The personal nature of this lecture reminded me why I chose to pursue a career in medicine—I wanted to be able to help people on their worst days.
As a future physician it will be my responsibility to take care of someone else’s grandpa and I realized that not taking advantage of the learning opportunities available to me would be a tremendous disservice. Also, if my grandpa wasn’t going to quit on his battle I couldn’t walk away from my own. Reinvigorated, I decided to stay in school equipped with a heightened motivation to excel. I hope to keep this wake-up-call in mind as a reminder of the importance of the material we are learning as I progress through medical school.
Lessons Through Illness & Death
After an intense week of fighting for his life, my grandpa eventually died.
I desperately wanted to attend my grandpa’s funeral but with my still mysterious illness it was unclear if it was safe for me to fly. Unfortunately, I was unable to undergo the brain MRIs necessary for clearance in time to attend the funeral. Listening to my grandpa’s eulogy through my computer was something I will never forget. It was a lesson in how isolating being sick can be, how lucky I am to have access to healthcare, and how devastating not having the privilege of timely medical care is—all lessons I will remember when I am a provider.
Shortly after my grandpa’s funeral my wife graduated from physical therapy school and moved to Vermont. I celebrated by having another biopsy and two days later underwent a 72-hour EEG. My wife helped me without ever complaining, but I can’t imagine this was the homecoming she imagined. Being sick and alone is one thing because it only really affects you. But when my health started to impact those I care for, it was awful.
In January when my symptoms slowly, mysteriously, and thankfully started to disappear, still with no clear diagnosis of what had plagued me for months, I’d catch myself questioning whether a bruise was just a bruise or if it would morph into something greater. If my heart rate was abnormally elevated while exercising, I questioned if it was the result of being deconditioned or if it was something more severe. These instances taught me about the paradox of illness anxiety disorder and I was once again reminded of the psychological battle that accompanies chronic illness.
Reflecting on this experience has helped me appreciate just how quickly a person can take on the identity of their illness, how truly isolating being sick can be, and the emotional burden associated with trying to get better. I found that each of these issues renders its own psychological toll—tolls that, as a future physician, I believe will be important to recognize in order to help patients navigate their own version of these experiences.
In a weird way, I’m thankful for my experience.
The day before my first medical school exam, my body started going haywire for no apparent reason.
I can’t begin to list half of the medical procedures I’ve had performed but I will always remember the little acts of kindness I received along the way. These acts of kindness can’t be found in my medical chart, yet made a major impact on my patient care. Medicine is a team sport and I owe a great debt of gratitude to everyone who helped me during my journey. I doubt I would have made it through on my own.
Now, as I approach the end of my second year of school, I’m happy to report that I’m doing well. Recently, I was able to complete a half IronMan race with my classmate, John Fernan, to celebrate the anniversary of first becoming sick.
By sharing my story, I hope I can pay forward some of the kindness I received and lessons I learned to help someone who may benefit from my experience.