Saint Louis University

Author: Liz Coorey
Published: Thursday, November 10, 2011

Aha moment (noun) - a moment of clarity, a defining moment in which you gain real wisdom - wisdom you can use to influence your life.

Have you ever looked back over several years and questioned all of your major life decisions? Have you asked yourself, "Am I doing this right? Is this really where I'm supposed to be?" I sure have. After dedicating four years to earning a bachelor's degree in dietetics, investing countless amounts time and money to both an education and those invaluable "resume builders", and committing to one of the most intimidating journeys I may ever embark on (a Dietetic Internship).... I couldn't help but wonder if it was all worth it. Is being a Registered Dietitian really my life calling? Well fortunately, all of these questions were answered for me after just a few short weeks at SLU and one outstanding patient experience.

Two rotations into my DI at SLU, I found myself at a small outpatient clinic that offers the services of its two exceptional dietitians to community members, free of charge. The patients seen by the RDs here run the gamut from diabetics, to bariatric surgery candidates, to those who need advice for managing food sensitivities. Some patients have been "frequent flyers" for years.. probably not because they need the education, but simply because they love to chat about food and share their struggles and successes with someone who is willing and anxious to listen.. and they've got some brilliant RDs to do that with!

Having the opportunity to sit for more than an hour at a time with patients who have chosen to meet with an RD and are truly invested in your time together is a rewarding experience in itself. But in all the patients I had the opportunity to meet with, none was more inspiring than a young woman, we'll call her Jane, with some serious GI struggles.

Jane's story begins about 5 years ago when she was diagnosed with acid reflux for which her doctors could find no solution for relief. In desperation, Jane's physician recommended a laparoscopic anti-reflux surgery. Jane had the surgery and found no resolve of her symptoms. A short time later Jane was diagnosed with a hiatal hernia, which is a condition in which part of the stomach sticks upward into the chest, through an opening in the diaphragm. Jane's hernia was severe enough to require three correctional surgeries and eventually led to significant damage to her esophagus. Unfortunately, the damage was critical enough to require an esophagectomy, which is an upper GI surgery in which the esophagus is entirely removed and part of the stomach is used to take its place. During the course of her illness and resulting surgeries, Jane developed severe iron, protein, vitamin B12, and vitamin D deficiencies. Her condition was further complicated by the development of Celiac disease (gluten intolerance), a lactose intolerance, and a soy allergy. By the time I met her, Jane was severely underweight, was beginning to lose her hair, and had noticeable skin degradation. She was experiencing significant GI discomfort due to the frequent occurrence of dumping syndrome and its resultant hypoglycemia, which were likely caused by eating the wrong things in the wrong amounts post-esophagectomy. Needless to say, Jane and her incredibly concerned, supportive parents were at the end of their ropes. They had had countless negative experiences with physicians and had never met with an RD for more than 15 minutes at a time. After such a discouraging journey, they were desperate for help, but had little hope that they would ever find it. Jane was understandably depressed. She couldn't maintain a job and as a young adult, was entirely dependent on her parents. All she wanted was to be "normal."

Enter: My preceptor and RD at the site, and Jane's light at the end of the tunnel.

While I observed from my spot at the end of the table, absorbing as much information as my overworked and filled-to-capacity dietetic intern brain could handle, the RD worked her magic. As she explained post-surgery recovery needs, nutrient density, dumping syndrome, food sensitivities, symptoms of protein deficiency, hypoglycemia and the proper way to correct it, meal planning, food substitutions, and on and on and on, I saw a light bulb grow from a dim flicker to a radiant, 100-watt shine over the heads of Jane and her parents. The session lasted over two hours, but they finally had answers to their questions. And better yet, they had solutions that didn't involve scalpels and wouldn't drain away their life savings. The relief I saw in the eyes of Jane and her parents and the immense gratitude they expressed repeatedly to the RD cannot be described in words. At one point toward the end of the session Jane and the RD stepped out of the room and I was left alone with Jane's parents. During that time Jane's mom began to describe to me the stress the previous five years had brought to her and her husband. She described multiple rushed trips to ERs, nerve-wracking hours spent in surgery waiting rooms, and countless worry-filled, sleepless nights. But when she looked at me with teary eyes and smiled, I saw that she realized that things were about to turn around. And it was all thanks to one talented and passionate dietitian.

Later that day, after the threesome left, my preceptor explained to me that it is because of patients like Jane that she loves her job as a dietitian. She knew that the education she had provided would lead to much more than an improvement Jane's physical health. She had, without a doubt, changed Jane's life for the better. I can't even imagine a more gratifying experience.

I drove home from my rotation that afternoon with that same shining light bulb hanging over my own head. I realized that if some day I can do for just one patient what my preceptor did for Jane, I will be content. And for that reason, I am finally confident that this path to becoming a Registered Dietitian is the right path for me. This was my "aha" moment!