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Our patients are more than the sum of their parts

Anonymous
Patient
October 19, 2013
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As a nursing student, I have always enjoyed the opportunity to see firsthand new procedures, treatments, wounds, and wound care on patients. Many of the patients were older and resided in the nursing homes where we conducted our clinical rotations. It was not unusual for several of us to gather around a patient while the wound care nurse or doctor cleaned, debrided, and dressed a pressure ulcer. For us students, the chance to observe and assist was always met with excitement.

However, most of the time, the patient was given little thought, as though they were no more than a body part to show other doctors, nurses, and students. Although many of the patients were admittedly demented, I sometimes wonder if we could not do a better job of retaining their humanity during the process. Reflecting on my own experience, I always tried to remember that there was a living, breathing person attached to whatever body part we were examining.

Years ago, I was in a particularly volatile relationship. I was cut off from friends and family and convinced that they would not help me. I had no access to my phone (and if any male friends called, I would later have bruises to show for it), nor did I have access to my car or money. He regularly beat me, forced me to engage in acts with others, and slept around, bragging about it. When he hit me in public, people would look away rather than intervene or help. When I finally summoned the courage to leave (which involved taking back streets and a taxi in the middle of the night with nothing more than my purse and the clothes I was wearing), I went to the police. A female officer told me she did not believe me.

All that aside, I had to go to the emergency department because he gave me herpes (the primary outbreak tends to be severe, and I did not have a doctor nor was I in a position to find one and wait for an appointment). Condoms were not an option because I had little say in anything, and often had no say in whether or not we had sex in the first place.

There I was, 18 years old, humiliated, ashamed, and thinking this was the end of my life—that no one would ever love or want me again—while the doctor performed a pelvic exam and gave me the diagnosis I already knew.

Here is where my point comes in: While the doctor was examining me, I showed him my finger, which I thought was infected from a cut. He looked at it, then brought in another younger doctor (or student) and showed it to her, explaining that it was actually herpetic whitlow. I was lying on the exam table, still undressed with my legs in stirrups from the pelvic exam, crying and ashamed of the diagnosis and everything that had led up to it. The doctor decided it was a perfect time to use me as a teaching example.

I understand the importance of doctors and medical students being able to observe new or rare procedures, exams, or illnesses firsthand. But do not dehumanize your patient, especially when they are awake, alert, oriented, and obviously uncomfortable. In my case, I probably would not have minded the doctor bringing others in if he had simply asked my permission first. Had he explained what was wrong and why he wanted to show others, and allowed me to sit up and put my clothes back on first, I most likely would have gladly let him bring in whomever he wanted.

In our excitement to teach and learn, we must be careful not to forget that our patients are human.

The author is an anonymous nursing student.

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Our patients are more than the sum of their parts
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