The Importance of Patient Advocacy

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“Hey Laura, can you come pick us up? Carly got another migraine.” 

I sighed and picked my car keys up from my dorm room desk. This was the third time my undergraduate roommate had gotten a debilitating migraine in the last few weeks, and I was starting to worry about her. 

When I arrived in downtown Seattle to collect my friends, I noticed that Carly was acting very strange — almost delirious. As I drove back to campus, she had a hard time finishing sentences and kept leaning forward in her seat. I decided it was time to go back to the emergency department. 

This was our second visit to the ED due to her odd symptoms and, just like our first visit, she was triaged as low-priority and we were designated to a gurney in a hallway. 

I tried to distract her as her pain medications began to kick in, pulling out some flashcards for an anatomy class we were taking together. We continued to wait for a room, and eventually she drifted to sleep. When we were finally greeted by a physician, I expressed my concern that we were once again in the ED. The severity of her recurring headaches terrified me. The provider seemed distracted and unconcerned, but informed me that an MRI would be the next step. After many hours of restless waiting, we left early the next morning.

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The results were sent to her primary care provider, who called a few days later — just before we left on a spring break road trip. The provider asked her to come into the office with a trusted friend or family member. In this appointment, she was informed that her headaches were caused by significant build-up of cerebral spinal fluid in her head and a suspicious mass growing in the middle of her brain. It was not what any of us had anticipated when Carly complained of headache. The news was shocking and unsettling. 

The primary care provider commented that the timing of the MRI scan was vital because, if this had not been caught when it was, it had a high probability of becoming life-altering or even fatal. That MRI may have saved her life. Reflecting on this experience, I am impacted by the importance of patient advocacy. 

I can barely fathom what would have happened if the ED provider had not listened to our concerns or taken us seriously. It would have been absolutely devastating for my close friend to suffer a worse outcome due to a delay in diagnosis. While her condition persists, I am grateful to have had an opportunity to participate — even in a small way — in helping her access crucial care. 

As I near the end of my first year of medical school, I keep this story in the back of my mind when I consider how to listen best to my patients’ concerns. 

I plan to keep an open mind and consider all options without jumping to conclusions about diagnoses. I will strive to ask thoughtful and directed questions in order to allow the patient to share their experience. I also acknowledge the importance of being non-judgmental and open to all patient worries. As my clinical exposure accumulates, I am confident that the influence of each lesson will improve my ability to provide holistic and effective patient care.

Laura DeWald

Osteopathic Medical Student - 2nd Year (OMS II)
Pacific Northwest University of Health Sciences

Laura DeWald