In our previous post, MS1 Chris Corbett shared his experience so far with the LEAPP program. Today, MS3 Sarah Huepenbecker shares how LEAPP impacted her medical education over the last two years.
When I first met my LEAPP patient, Ms. M, I knew I was going to have an enjoyable experience. She was easily the most gregarious patient in the dialysis unit, and greeted my LEAPP partner and I with a huge smile and hugs. Her outfit and accessories were completely color-coordinated (a recurrent theme), and her blonde curls swung jauntily (a non-recurrent theme, as each subsequent visit introduced a new wig).
She launched right into her life story, telling us all about her career as “the dancing barmaid,” her two trouble-making sons, and her new fiancé. It took us a while to steer her towards telling us about her chronic disease: end-stage renal disease secondary to hypertension and diabetes.
In some ways, she had remarkably good insight and knowledge about her disease process—she could explain why she needed a low-salt diet, how the dialysis machines purified her blood three times a week, and the specific symptoms of uremia (a term I only vaguely understood at the time). I was struck by how upbeat Ms. M was about her diagnosis and prognosis—she enjoyed seeing her friends at dialysis three times a week, loved her nephrologist, and had lots of plans for her future.
This initial impression was a lasting one, and I always looked forward to my sessions with Ms. M. As my LEAPP partner and I met with her more often, we were able to get to know Ms. M as a vibrant person instead of just as a patient. By learning about Ms. M’s life outside of her disease, I was able to appreciate how various psychosocial, emotional, religious, and financial variables factored into her health.
For example, a few months after our initial meeting, Ms. M moved into a new apartment, which was both more affordable, allowing her to spend more money on fresh foods and maintain a renal-friendly diet, and closer to the bus stop, allowing her to travel to and from dialysis more easily. On the other hand, when Ms. M’s brother died unexpectedly midway through our LEAPP experience, she was deeply shaken and skipped several dialysis sessions and doctor’s appointments, which ultimately led to a few ER visits. During our year and a half with Ms. M, she went to the ER 5 times and was hospitalized twice (once for a clot in her dialysis fistula, once for a leg wound infection). It was a humbling experience, as a budding medical student, to see the progression of end-stage renal disease up close and personal. The bigger lesson, however, was seeing how the disease impacted Ms. M’s life and hearing her perspective on her own health.
Ultimately, my LEAPP experience gave me valuable insights that I will carry with me throughout my career. I had the privilege of getting to know a patient who was alternatively incredible, smart, energetic, non-compliant, scared, hopeful, and frustrating. I was able to see my patient as an utterly and beautifully human person with a life outside of her disease, and I hope to never forget that lesson as a physician.
Sarah Huepenbecker is an MS3 who is interested in OB/GYN and General Surgery. She is originally from Minnesota and completed her undergraduate degree at Penn in 2012, majoring in Biology and minoring in Hispanic Studies. In her free time she enjoys running, reading, good happy hours, and guilty pleasure TV.