By Roberteen H. McCray, DO; member, ACOFP Diversity, Equity and Inclusion Task Force

Salutations, everyone! I’m back with another installment of Causal Conversations. This next story comes from an experience during my medical school years…

Now, I can imagine what some of you may be thinking: You were a medical student, so you are at the bottom rung, what could you have possibly experienced? Well, I had made it through the first two years of classroom study and Step 1 and was imitating a sponge trying to absorb everything that I could during my rotations. I cannot remember if I was in my third or fourth year; what I do remember is on that particularly hot July morning, I was doing wound care rounds at a long-term acute care facility (LTAC) in Las Vegas.

The team consisted of two nurses, the attending physician, a classmate and me. We had seen 10 patients who had pressure ulcers in various stages of healing when we got to patient number 11. She was a 56-year-old, Caucasian female newly admitted into the LTAC following discharge from a local hospital after undergoing bilateral lower/below-knee amputations. We went in, checked her wounds and discussed her treatment plan. The atmosphere in the room was so negative, and the patient was not pleasant.

Because it was my responsibility to re-cover her wounds, I was the last person in the room. As I started to walk away from the patient’s bed, she called out and asked me to stay for a moment. She then asked if I would adjust her pillows and put them behind her head. It seemed like a simple request, so of course, I agreed. She had two pillows that were down near her lower back. I took the first pillow and slowly brought it up her shoulders with the intention of bringing the second pillow up and placing it behind her head as the patient would not even sit forward after being asked.

As I was placing the second pillow behind her head, she turns to me and snarls, “’Are you stupid? I asked you to put the pillow behind my head, you Black b—-!” Now, I had my hands on one of the pillows and could have responded by snatching the pillow out, dropping it in her lap and walking out of the room. Instead, I moved the pillow higher and calmly replied, “I am putting the pillow behind your head, but you won’t sit forward like I asked, so I am gradually moving the pillows up so I won’t jar your body.”

The patient then just looked at me and didn’t say anything else. I also had no additional words for her and finished adjusting the pillows behind her head and walked out of the room. It was then I realized that the rest of the care team was standing in the hallway and had seen the entire exchange.

My attending was quite upset and asked if I was OK. I was fine—taken aback—but fine. I understood that the patient had an unexpected life-altering situation. She was hospitalized and placed on multiple medications to keep her alive. She was admitted in critical condition, but had both of her lower extremities and was later discharged as a double amputee. She was angry and, at that moment, I was the one she lashed out at.

The lesson that was reiterated that day was: Take a moment and evaluate the situation before responding. Ask yourself how you would feel if you were in that situation. My heart went out to that patient, even though I was not happy with the way she spoke to me. At the same time, I was so grateful that not only was I healthy, but I also did not respond to her the way she responded to me.

My hope for the patient was that she would quickly heal emotionally, spiritually and physically and would quickly be fitted with prostheses as soon as possible. Would you have hoped for the same?

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