The man in scrubs stands in the middle of the room. He has a blood-filled syringe in one hand and hand-written lab notes on the back of\u00a0an envelope in another. He scans the room, looking for someone or something. I follow his gaze. A young man is curled up in a ball on the floor, rocking himself back and forth while groaning in pain\u00a0(gangrenous wound on leg).\u00a0A man is throwing all his weight\u00a0on his wife and yelling\u00a0in pain (renal colic). A woman is holding a piece of red, soaked gauze tightly on the hand of her screaming 7-year-old son (amputated finger). An older woman in a wheelchair is drooling from one side of her mouth and has a drooping shoulder (stroke). A young man, handcuffed to a police officer, has circular marks around his neck and blood dripping from his mouth (suicide attempt with hanging and ingesting barbed wire). A young woman sits limply in a wheelchair, eyes rolled back, and blood on her clothes between her legs (severe anemia –\u00a0abortion days prior). In this room no bigger than my mother’s walk-in closet, the suffering is palpable and audible, but the man in scrubs does not find what he is looking for, and begins to walk out. Before he reaches the door, an unconscious man is carried in to the room (antifreeze ingestion). Without missing a step, he reaches over and gives the man a rough sternal rub to wake him up, to no avail.\u00a0He exits the room.<\/p>\n
The man in scrubs is the sole medical resident in charge of the stabilization and triage of incoming patients at this Emergency Department situated in a Low and Middle Income country. As a visiting medical student, I am wearing a white coat, and although I should fit in, my general ignorance about the majority of relevant things makes me feel like an imposter. I shouldn\u2019t be here. I shouldn\u2019t be wearing this white coat.<\/p>\n
\u2018You! You can help me!\u2019 exclaims a woman in a wheelchair as she reaches towards me. Her face is covered, but somehow I know that she is in pain. Reluctantly, and with as much grace as a fish on land, I walk towards her. I walk towards her knowing that the only care I can provide is a hug, a tear, or a smile; the only\u00a0prescription I can write is a kind word, and the only order I can put in is a prayer to the heavens.<\/p>\n
I came to medical school to gain the skills that I need to better care for my neighbors, to\u00a0share moments of humanity,\u00a0of suffering and healing with my neighbors, to\u00a0be\u00a0meaningfully\u00a0curious –\u00a0to ask and answer questions that benefit my neighbors and\u00a0our community, and to use medicine as a platform to\u00a0implement meaningful social change. The irony is,\u00a0I see none of that now; all I can do is stand defeated as I\u00a0watch my neighbors suffer. I\u00a0watch\u00a0because I don\u2019t have the money to cover the 15 pounds admission fee for every patient that is turned\u00a0away at the door of\u00a0the ED. I watch because I don\u2019t know whether that comatose child who was just intubated is in trouble\u00a0because his stomach is inflating instead of his lungs. I watch\u00a0because I don’t know if that medical student just injured that woman’s radial nerve while trying to get an arterial blood sample.<\/p>\n
With tears in my eyes, I fumble out of my white coat and head for the exit. I\u2019m done watching, I tell myself. I\u2019m done watching and\u00a0I\u2019m ready to learn. I\u2019m ready to learn how to care for\u00a0the suffering. I\u2019m ready to\u00a0be a part of the change I want to see in\u00a0the world.\u00a0As the door of the ED closed\u00a0behind me, I managed to catch a\u00a0final peek of the\u00a0chaotic scene,\u00a0as if to tell myself,\u00a0\u2018I will return when I\u2019m ready.’<\/p>\n
Looking back, I wish I had kept my white coat on, even if just to care with a tear, heal with a kind word, and pray for the well-being of my neighbors.<\/p>\n