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Shot in the Arm

What a pint-sized patient taught me about bedside manner.

by Michael Wolf, M.D. candidate, Class of 2012

SPOVSummer 2009  |  Share This  |  E-mail  |  Print  | 
(4 votes)

medstudent“So, what is med school anyway?”

I could have brushed the question off. I could have answered sarcastically or changed the subject. But the assertive innocence of this 8-year-old girl compelled me to come up with a serious answer.

She and her mother were patients at the Shade Tree Family Clinic, a free clinic directed and operated by Vanderbilt medical students. She had come in with a minor cold, so we treated her symptoms and told her to get plenty of rest. Her mother had come for more personal reasons, which required that someone keep the little girl busy in the waiting room. In the room were the girl, her mother, the fourth-year medical student I was following, and the Spanish translator.

Because I was clearly the least useful team member at that moment, I volunteered to baby-sit.

So there we were: a first-year medical student and a pint-sized 8-year-old with straight black hair down to her waist, and piercing eyes that seemed to cut through even the slightest hint of condescension. We stood in the middle of the tiny, crowded waiting room of the clinic—more of a trailer, really—because all the seats were occupied by patients waiting for appointments. Quarters were close enough that I could see the reactions directed my way, ranging from knowing nods to smirks that seemed to say, “Let’s see you talk your way through this one, kiddo.” Man, this was not going to be an easy answer.

“Well, medical school is a place where people go to learn how to be doctors.”

“Right, I see. So you’re, like, students. Not doctors.” (Uh-oh.)

“Not yet.”

“OK, so then … what if you … like … make a mistake or something?” (Man, this girl is astute!)

Wolf“Well, there are doctors here to make sure we do the right thing. They check our work, do the things that we can’t do yet, and also help us learn. There’s a doctor over there.” I pointed out Dr. Robert Miller, the clinic’s medical director. “You can tell because his coat is longer than mine. He’s on his way to talk to your mom.”

“Ooooh, OK. So, am I going to get a shot today? I heard that girl over there [the fourth-year medical student] say something about a flu shot.”

“Well, if the doctor thinks it’s a good idea, then we may need to give you one. It’s just a little stick to keep you from getting the flu.”

“How?”

Oh, man, she doesn’t quit.

“Well, do you know about germs?” I asked, going by the seat of my pants, as she nodded. “OK, so your body makes things called antibodies to fight germs. But first the body has to know what those germs are like. It needs a head start so it can get ready to fight off the bad stuff. So we give you a little sample for your body to use.”

“Oh, like a vaccine. I got those already when I was a baby, and my mom said once you got one you couldn’t get that type of germ for life. Right?”

“Well, sort of,” I answered. “But the flu likes to change, so people need to get them every year so their bodies can keep up.”

“OK … I guess. Will it hurt?”

“A little,” I said. My mother and my small-group discussion leader taught me never to lie. “But it is over really quickly, and you can squeeze my hand as hard as you can until it’s over.”

(Cue the nervous look and the quivering lip of doom. Waterworks are next. I need to think fast.)

“You can even hit me in the arm as hard as you want so it hurts me, too.”

“OK.”

We talked a few more minutes about where medical school was (right next to the hospital), where I was from (faraway San Diego), and if it was fun to be a medical student (yes, except around exam time).

Back in the exam room, she took her flu shot like a champ and socked me in the arm like a pint-sized Joe Frazier. Hey, I asked for it.

“That wasn’t so bad, right?” I asked.

“No, it was bad,” she said with a smile. What a trouper.

But I wasn’t out of the woods yet. The pharmacy was swamped, as is often the case at our tiny clinic, and there was no liquid ibuprofen for the girl. And she didn’t know how to swallow a pill. Not wanting to let her go home suffering and unable to take her medicine, I coached her through the process. After a few gags, she triumphantly stuck her tongue out and said, “Done!”

We said goodbye, and the mother and daughter walked toward the door. Just as I was about to rejoin my fourth-year partner, the girl turned back and asked, “If I come back, will you be here again?”

I barely even knew what to say. I managed something along the lines of “I’m usually here one Saturday a month,” but truthfully I was too choked up to think.

It amazes me how such a simple gesture could affect me, a generally stoic med student, so deeply. That little exchange made my day, my week. I know it may sound a bit trite, like something you’d read in a medical-school admissions essay gone wrong, but I don’t care. I was on cloud nine. This little girl with a cold had reminded me why I had gone to medical school.

I know that not every patient I encounter will afford me the same experience. I know that I need to learn from the tough patients, the ones who are harder to like, and harder to care for. But that doesn’t stop me from hoping that I get to meet and treat many more like that kid.

 

© 2014 Vanderbilt University | Photography: JOHN RUSSELL | Illustrations: SPOTS ILLUSTRATION

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amy alpern says:

This Wolf guy is going to make an awsome doctor. He seems to already have what some doctors never seem to get. I’d love to see more of his articles.


Judith Dodds says:

I am a mother of two and this story made me tear up! It reminded me of when I was young and had to get shots. I was just as frightened as the little 8 year old in this story.

The difference?

I did “not” have such a warm, caring medical student help me through it. Thanks to Michael Wolf (medical student) and his kind ways she most likely will be telling this story to her grandchildren. What a fine story to share and tell.


David Alpern says:

This article conveys why people choose a health care profession – cuz of the ability to touch people so intensely as Michael wrote here.

For some, the lifestyle is too difficult – like 3 days of consecutive shifts with nearly no sleep – but this beautiful piece shows why all those lousy quality of life calculations get discounted in favor of more valuable factors like this little girl, by those such as yourself, who choose and love the medical profession.


Azmina Madsen says:

Reading this article was heart warming indeed. I await the day we have more physicians that put more time and connect with the patient one-on-one! The healing begins knowing that your doctor is really addressing you and your needs and asking key questions so he can find out what exactly needs to be done to help you. Your kindness and thoughtfulness in this article has brought you closer to the ideal doctor to be for the future and lucky will be the patents at the receiving end.


Anne Pawate says:

What a great story. I hope you plan on being a PED’S MD for you are the type of doctor I did NOT have as a child and wished I had.


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