Not Just a Medical Student

On a dreary and cold Thursday afternoon a week before Christmas, I walked down the hallway to the burn unit to see a new infectious disease consult. I grabbed the door handle only to be met with resistance—I had forgotten to tap my badge to unlock the door. Again. Just another moment to make me feel out of place, at the bottom of the food chain. “I’m just a medical student,” I found myself saying numerous times a day. I wondered if seeing patients and navigating the hospital would ever feel natural.

A nurse tapped her badge against the card reader and opened the door. I continued down the hall until I found my patient’s room, put on a gown and gloves, adjusted my face shield, and took a deep breath to calm myself before opening the door. As I entered her room, I was met with a smiling middle-aged woman eating an enchilada. My stomach growled as I remembered I hadn’t had time to eat lunch yet. I introduced myself the way I always did: “I’m the medical student on your care team today. I’m here to find out what brought you into the hospital and to get a better idea about how we can help you while you’re here.” The words had become second nature, but my role still felt uncomfortable. Every encounter with a patient felt like I was playing pretend. I knew, and my patients knew, that I wasn’t really a doctor.

We talked for a while as she explained how she had recently had surgery to put a skin graft from her arm onto her foot. She had struggled for months with a wound from a previous foot reconstruction surgery that was not healing due to her underlying diabetes. She had been in the hospital a week earlier with a post-surgical infection, and now she was back because the infection still hadn’t resolved. She asked me what we could do and why the previous antibiotics didn’t work. I gave her the best answer I could, talked about some of her options, and I made sure to mention my attending would be there later to go over everything in more detail.

I then asked if I could examine her, and she happily obliged. I put my stethoscope into my ears and disappeared into my own thoughts as I listened carefully to her heart and lungs, both of which were normal as far as I could tell. I continued the exam, checking her neurological status and then looking at her wounds. The infected foot was wrapped in a bandage and strapped into a walking boot. Her arm was also still bandaged from the graft surgery. Right foot, left arm. I made a mental note for later when I would document her physical exam. She looked at me and asked if I wanted to see the wounds. “Oh, I’m just a student,” I found myself saying yet again. “I don’t think they’d want me to mess up all the bandages.” She chuckled and said, “Well, I’m an expert at putting this gauze on after all this time. If you want, we can do it together. I’ll show you.”

She took my gloved hand in hers and directed me toward her arm first. I began to unwrap the carefully-placed gauze, and she explained how rolling up the bandage as you go makes it much easier to reapply later. I continued unwrapping and re-rolling until her arm was exposed and I could fully examine her wound. We did the same with her foot, and then she guided me through

the process of redressing her wounds. I stayed with her for a few more minutes. We chatted about her favorite Christmas cookie recipe, the best holiday movies, and what it was like to be a medical student in a pandemic. As I was leaving her room, my hand on the door handle, she said one last thing that changed my perspective: “You’re not just a medical student.”

I removed my gown and gloves, remembered to tap my badge against the card reader this time, and returned to the work room to write my note. I hadn’t done anything particularly special—I didn’t diagnose a rare disease, catch an easy-to-miss exam finding, or save this patient’s life. But I had made a difference in her day, and she had made a difference in the way I saw myself and my job. As a medical student, I had more time to spend with her than any of her other providers. I could hear about her special sugar cookie recipe and her foot infection. After a few weeks on the infectious disease service, I did have enough knowledge to give her a basic explanation of her problem. Her kindness and patience gave me just enough of a confidence boost to go outside of my comfort zone and realize I wasn’t “messing up” her bandages by doing a thorough examination. Yes, I am still learning the basics of medicine, but I’m not just a medical student. I have a lot to offer to my patients, and those 20 minutes in the burn unit were just what I needed to realize that.