By Jason Ha
Clinical Winner, Writing Competition 2017
Prompt 2: Tell us about an encounter with a patient that has significantly shaped your understanding of medical practice or changed your worldview.
“There’s an angsty patient out there—”
Over the hubbub in the nurse’s station, I could barely paint out a coherent description of the patient. 82 years old. Surgical Post-Op Clinic.
It made sense – she had had surgery just over a month ago, and she was attending for a review appointment. Just one of about several thousand patients the hospital treated each year. And like the statistics, she was a number on our screens, with an adjacent ominous timer displaying 1 hr 40 mins, blended within the cacophony of red and yellow flashing labels.
“Just tell her she’s got to wait her turn, or she can go home—”
“—can’t she see we’ve just had a code blue back here?”
She was hunched over the bench, one hand clutching at her purse, the other gesturing frantically, at the staff, at her watch, at her letter. You could barely make out the ponytail of a little girl, no more than ten, tugging at her arm, hardly making eye contact, as she was jostled this way and that, out of the way of the trolley rolling down the corridor full of patient files, only to quickly dodge another particularly mobile patient with a walking stick.
Though even among the clamour, you could pick out a few snatches of the conversation.
“You’re going to be seen by the doctor very soon – no, no, uh—have a seat over there and they’ll call out your na—no, not yet—”
There were audible sighs of frustration: one of frustration from the ward clerk, and the other of defeat from the patient. During that entire time, it hadn’t even been a conversation, just a perfunctory attempt at assuaging patient concerns, and an equally blasé approach to address the underlying problem: she spoke no English.
By the same token, the clerk understood none of her language and the poor granddaughter was far too bewildered by the diatribe at the desk to be of any help.
All this time, the ward clerk looked increasingly confused, a look of desperation apparent on his face, as during this exchange, a queue had started snaking through the waiting area, trailing beyond the glass doors with no end in sight. It didn’t help that there were patients already asked to offer their seats to more needy patients. This was just ‘one of those days’, just another day to get through, another patient to ‘check in’.
As she turned away, seemingly defeated by the sheer inability to understand, our eyes met. She offered a weak smile, a look of recognition almost, and for the briefest of moment, I hesitated.
I knew I could speak her language, but what could I offer her? I couldn’t expedite her appointment, I couldn’t examine her in the waiting area, let alone find her a seat among the sea of heads, all craning forward for any sign that they might be called next.
There was still another half an hour before my next patient was expected, so what did I have to lose? I mustered my courage and approached her, a few tentative phrases in our common language at the ready.
“Auntie, is everything alright?”
In an instant, a wave of relief flashed across her face as she clasped my hands tightly. “Finally! Someone who understands!”
As I found out in the ensuing half an hour, she had been taken for imaging and was particularly anxious she had lost her spot in the queue to see the doctor. This was someone lost in a disorienting hospital environment, bounced from ward clerk to nurse to radiographer, hoping to discern some order from the chaos.
As I saw her afterwards as she left the hospital beaming, she uttered a few words of thanks. But I hadn’t been part of her treating team, nor was I officially employed by the hospital to help on with administration. I had been there serendipitously, somehow able to offer a hand, and yet I feel humbled to know that those precious few minutes with her may have made the biggest impact to her healthcare experience that day.
But this is not a singular case. When we see our patients, they are at their most emotional and vulnerable.
This is the elderly Greek man who says Ναί (yes) to signal his approval, much to the confusion of his treating team.
This is the recently migrated mother-of-two who nods and smiles knowingly at the nurse and anaesthetist when asked about her allergies as she is being prepped for her procedure.
This is the delirious patient in Bed 16 who begins tugging at his cannulae, unaware that they are providing the very medication that is preventing their organs from failing.
We’re told early on to remind patients that we’re not doctors, just medical students. But in the eyes of a patient, it doesn’t matter: we are a little cog in the big hospital machine, and the little assistance you can afford in demystifying the experience, however small, is invaluable.
After all, this reveals one of the most profound parts of the human condition: we seek to be heard, to be understood, to be listened to. In this particular case, that communication breakdown was largely due to a language barrier, but words are just mere grains of sand swept along in the communication exchange.
We strive to be the best doctors possible. It doesn’t start when we finally graduate from university – the moment we step foot in the hospital, we can do as much as the most experienced consultant only if we choose to listen.