Class of 2015
I spent six weeks in Salvador & São Paulo, Brazil on an unofficial elective in both gynecology and ophthalmology during the summer of 2013. Most of my time was spent in private hospitals― those that serve the upper middle class with private insurance. However, I also had the opportunity to spend a few days in one of the public hospitals in Salvador.
Walking into a public hospital one morning, I was taken aback by the striking difference between it and the private hospitals I had already visited. It was hard to believe that a rundown building with only basic amenities was just a short drive away from a private hospital with marble floors, a restaurant and state-of-the-art equipment.
I shouldn’t have been surprised, though; the stark contrast between poverty and wealth is everywhere you look in Salvador. Next to apartment buildings with pools and fitness centres protected by security guards are slums on hills where the poor live.
It wasn’t long after I’d changed into public hospital scrubs that I was thrown into the thick of things. A young woman had arrived in labour, which progressed very quickly. Her baby was ready to make its entrance into the world when I showed up at her bedside.
The woman in labour couldn’t have been older than twenty, and she had shown up to the hospital all alone. She had no analgesia to ease her pain, and no family or friends to press a cool cloth on her forehead or to feed her ice chips. All she had was a crowd of strange faces yelling at her to push. Then there was me, the white girl, clearly looking out of place among the Bahians.
I wasn’t much help, medically-speaking. Other than knowing how to say “please” and “thank you,” my Portuguese was fairly limited.
As I watched this young woman struggle through labour all on her own, sweat and tears dripping down her face, I realized that maybe I didn’t need a mastery of the Portuguese language to show her that I was there to support her. Even though I was a foreigner with little to no clinical experience, maybe I could be of some help.
Standing at her bedside, I reached out my hand, and she grasped it tightly. She looked up at me, and the grateful look in her eyes said more than words ever could. I gave her both of my hands to squeeze until she no longer needed them.
Nine months later, I was in clerkship, on my OB/GYN rotation. One afternoon, we had an older woman who was there for her colposcopy, and it turned out she needed a biopsy. Even though she said nothing, her nervousness was almost palpable―her gaze was fixed determinedly on the ceiling, her fingers clutching her hospital gown tightly.
Though we both spoke the same language, I didn’t need it to communicate. As my resident performed the biopsy, I stood by the patient’s side and reached out my hand once again. She grasped it eagerly, then reached for my other hand, holding on as though I was her lifeline.
After the clinic, I ran into the woman in the hospital lobby. When she spotted me, her face lit up.
“I just wanted to say thank you,” she said. “You were so sweet to me; it was such a help.”
Encounters like these allow me to reflect on the relationships we form with the patients we see everyday, whether on the operating table, in clinic, on the floors, or in the emergency room. I’ve learned that it’s the simplest gestures that can form a strong bond between healthcare professionals and their patients. I try to keep this in mind whenever I’m in the hospital. It’s all about the touch of a hand, the understanding smile, the squeeze of a shoulder as I go to leave.
I believe these things speak louder than any of the words you say to someone. I can only try to hold on to that belief as I move forward in my medical career.
Jamilatu Yidana Gubbels
Lisa, I enjoyed reading your insights on how the simplest gestures can forge a strong relationship between a health professional and a patient. Often it is forgotten in practice that simply maintaining eye contact, smiling and touching a person can have immeasurable value and meaning to the person receiving it. I can definitely confirm that observation with my own experience.
In mid May of this year, I was two months shy of finishing my first year of medicine in Havana, Cuba, when I had to be hospitalized with a high risk for sponatneous abortion pregnancy. The doctor who attended to me was phenomenal and you could tell he was an expert in his field. However, after an episode of bleeding, which made me fearful of losing my baby, a resident or a student (I do not remember him clearly introducing himself to me) came to update my medical history. He barely looked at me the whole time instead his eyes were glued to his paperwork. Once in awhile he would ask clarifications from my husband barely making eye contact with him as well. I remember feeling like I did not exist at all and that he could care less about me. I knew that was not his intention because it was obvious he was nervous and unsure of himself.
If only he had acknowledged my presence by simply maintaining eye contact with me through our interaction, I would have not felt the way I did and would have probably felt reassured by his kind gesture of empathy through eye contact.
It is intimidating pursuing the medical career and often I feel out of my element and insecure. I learned that day to make every effort to not lose sight of the importance of simple human gestures that cost nothing to give and yet create a strong palpable therapeutic bond between the patient and the health professional in his/her most vulnerable time of need.
Thanks for sharing all of that with me, and I agree 100% with your points. I’m also sorry that you had to go through that; I hope everything you’re doing well!