“Hello, my name is … and I am a medical student.”
“Hola, mi nombre es … y soy un estudiante de medicina.”
These are the usual first utterances from my mouth when I walk into a room to greet a patient. Normally, these words are met with a response, whether it be a smile, a few words or a simple address. However, this time, it felt like it hit a wall, reverberating back to me, with the silence and lack of acknowledgement resonating in my ears. The patient had her head down, playing a game on her phone — a virtual interaction taking precedence over the real, actual person in front of her. As I sit down and work towards putting together another phrase, my brain signaling to my tongue and my lips to produce sound, the patient looks at me. She tilts her head. Her eyes are yelling at me with annoyance and bother, but her mouth tells a different tale — an uncoordinated dance between her wants and her actions. She greets me. I proceed to ensure her comfort with me being there by asking her questions, in order to “work together” to hopefully find a solution to the reason she is here. I do this even if she would have preferred me not be there taking in the same breath as her, inhaling the stench of Clorox used to clean the exam table before her.
Though she agrees, the wall from our initial recognition of one another remains strong and thick, still serving as a barrier for my words to reach her — for my words to matter to her. However, I remain optimistic, still determined to accomplish my goal. I began asking her questions to better understand the reasons surrounding her visit, like “When did this start?”, “Have you ever had anything like this before?”, “What else did you experience with this?” With each question, I found more details than I intended — ones not within my exchange with her, but rather, ones from inside her own internal dialogue. “It happened yesterday while I was working … These past few months have not been great … I have never had anything like this in the past, but who knows, maybe this is what I should expect … I vomited one time and I have had stomach pain since. I am not sure when this pain will go away.” Here, I am struck by my own thoughts surrounding that conversation with her — my thoughts, which appear more demanding to her than my cadence, my tone, me.
As I continue with my questioning, she stops me and asks me about my last name. I tell her about my family. She asks me if I can speak Spanish, to which I regrettably deny, stating I can understand it well, but my ability to communicate in my mother tongue is lacking. Her eyes catch my sight, this time not projecting annoyance, but now disappointment, with her head shaking and her uttering, “That is an absolute shame. You should know how to speak Spanish. You are Hispanic and do not know Spanish? What a shame.” From then on, that wall that stood between us widened, with another one fresh from construction in front of it. What was already an encounter met with resistance and convoluted conversation turned into one of a lack of respect and regard for me, both as a medical student and as part of the Hispanic community.
From the moment I walked into the room, the patient, being a part of the healthcare industry herself, placed her judgements on me, for being a student and not a “provider,” which was only exacerbated by, in her eyes, my lack of true identity with my native heritage. This bias against me for being a “non-member” of her care team and a fake member of her (and my) culture meant that my words were now not only met with the defenses she had installed against me prior, but the reinforcements she recruited from then on. My words, once again resonating within my ears alone and vibrating the ossicles to transmit the electrical signal, too were falling on deaf ears. The interaction with this patient had me reflecting on my ability to not only be a medical student and a future provider, but also to be someone who identifies with their culture to be a member of their community, to be a person who has strived to overcome the obstacles and challenges placed before him to be one of the few Hispanic physicians in the United States and the first in his family. And yet, I was not enough for her. I am not enough for her.
Through our continued, muted discussion about her chief complaint, she reveals to me a vulnerable aspect of herself, one that went beyond my questions. Her husband had been unfaithful to her. I now finally could hear the innermost voice, not the one in my head, but rather hers. I was able to listen to the unspoken words hidden in the produced sounds. Pain. Grief. Anger. And because she was unable to express those feelings toward the intended recipient, I became her target. With the added perceptions she had of me, I had not walked into a patient’s room, I walked into a storm of emotion, with its eye on me at the center, unbeknownst to me.
I left that encounter reminding myself what I am doing this for. Who I am doing this for. Despite the biases directed toward me, whether the patient’s intent or not, I am reaffirmed in my purpose of being here. I am doing this in order to work with people at their most vulnerable and listen to people’s innermost worries and dialogues. I will use this encounter in the future to remember we are all people, complex and with more layers than we can perceive, or choose to understand, which will always influence the multifactorial nature of being.
I am grateful to learn from so many individuals throughout this journey, especially our patients, as they often have the most to teach us, even if it feels like they do not want to. Everyone has gone through, is going through and will go through experiences that will alter who and how they are. Sometimes, we will be the receiver. Other times, we may be the deliverers. But if this encounter demonstrated anything to me, it is that we are tasked with seeing beyond, maintaining our resolve and attempting to breakthrough, even if it’s one brick at a time.
“Hello, my name is… and I am a medical student.”
“Hola, mi nombre es… y soy un estudiante de medicina.”