The patient was a man
in his 40s, who had undergone four surgeries in 100 days to remove a stubborn
lung infection. He was facing the prospect of a fifth operation.
Caroline Nguyen met
him during a palliative care elective in her fourth year at the University of
Colorado School of Medicine. She spent hours talking with him about his life,
his illness, and his health goals.
One day he told
Nguyen “I feel like I’m being tortured. I can’t do this anymore.” He wanted to
discontinue life-sustaining treatment.
“He was a tough guy.
I’d gotten to know him, to know that he had struggled all his life and to know
that he knew what pain was. So when he said ‘This is too much,’ then it really,
truly was too much.”
Nguyen and her palliative
care team met with the rest of the team to discuss the patient’s wishes. After
more consultations, the medical team removed a breathing machine and he died
two hours later, surrounded by his family.
“It’s a hard outcome
because part of you wants to say ‘If you can just hang in there …’ Nguyen said.
“But he was clear. He was tired of being taken care of no matter the odds of
improvement, no matter the surgery that might let him go home. He told us, ‘I
understand, but I’m done.’”
The case reinforced Nguyen’s
belief that the best medical care requires listening to patients as well as treating
The experience also
reminded her why she walked away from a potential career in basic science
research after majoring in microbiology, immunology and molecular genetics at
University of California, Los Angeles.
“I loved everything
about research. I loved being able to ask questions in a scientific way and
figure out the answers in scientific way. I got to write a paper (on antibiotic
resistance) and go to a conference and speak in front of immunologists, which
was totally intimidating, but I knew my work would help a patient in the future.”
interested Nguyen. She was tutoring students in Watts while attending UCLA when
she realized medicine would be a good combination of science and teaching.
“Basic science makes
my brain happy. What makes my heart happy is when I sit next to patients and
get to know them and help them in a way that makes sense to them. So I chose
the path that makes my heart happy. I think it’s more sustainable for the
Not ready to walk
away from basic science research entirely, Nguyen joined the research track at CU
and studied treatment targets for inflammatory bowel disease.
Nguyen, a member of
Alpha Omega Alpha and the CU Anschutz Student Senate, got hooked on primary
care during her first year when a returning patient recognized her at a clinic.
“He smiled and said
‘Hey, Caroline, how are you?’ and I realized that it was that connection and
relationship with people that made a difference to me. I felt he I trusted me
because I knew him and what his life looked like. I knew who he was and could
help him the best way possible.”
The daughter of
Vietnamese refugees, Nguyen learned to value empathy while growing up in
“I couldn’t speak
Vietnamese - I couldn’t even speak to my grandparents - so I didn’t fit into
Vietnamese culture. In school I didn’t fit in because I didn’t look like my friends,
I didn’t dress like my friends, I didn’t eat the same food as my friends. There
was always a narrative of non-belonging.”
Her background helped
her empathize with a student she mentored for four years through the School of
Medicine Breakthrough Program, a student-run program that helps urban
underserved students. The girl, a Denver high school student, was born in
“She became very
afraid that her parents might get deported or that she might get deported. She
wants to be an engineer, but she didn’t know if she still had a future in this
country. I have no background in something that scary. I couldn’t even imagine
what that felt like for her.”
Once in practice,
Nguyen, 25, who will serve her internal medicine residency at University of California, San Francisco, intends to spend
at least half her time in clinic working with underserved populations, and the
rest in an academic setting where she can teach fellow physicians to be
“My focus in medicine
is communication,” she said. “People ask if empathy is a skill that can be
taught or whether it’s an innate skill that people have. I think that all
providers have some level of empathy that can be nurtured and fostered to help
bloom. There’s more science to it than just telling people to be kinder.”
She hopes to research
methods that will help physicians connect with their patients.
“I’ll probably never
get back to the pipette and the mechanical aspects of research. I’ll always
miss that. But I think so much of research is asking a question and figuring
out how to answer, how to measure and make progress. I will still be able to do