He is that new patient to the clinic.

You know the one.

He is the “multiple chronic conditions” patient.  Diabetes, hypertension, COPD, chronic kidney disease, congestive heart failure, arthritis — it would probably be quicker to name the conditions he doesn’t have. You let out a deep sigh before entering the room.

You know the one.

He is the “non-native English speaker.” English isn’t his first language, perhaps not even his second. You try to push through, but you can tell he doesn’t really understand. You’ll need to get a translator.  It would take too long to wait for one of the hospital translators, so you use an iPad or a telephone, maybe even his family member. This is going to be a long morning.

You know the one.

He is the “noncompliant” patient, as recorded multiple times across his charts.  His hemoglobin A1c is at least nine. His blood pressure is 180/90 on a good day.  He doesn’t have logs of all of his daily blood pressures or glucose readings. He has missed multiple appointments.  He isn’t sure which medications he is currently taking. There is no use in trying.

You know the one.

He is the “poor historian.”  He isn’t sure what date he saw the cardiologist or the pulmonologist or the nephrologist or the gastroenterologist. He doesn’t know when they raised his lisinopril, or was it his metoprolol? Something having to do with blood pressure.  He got a vaccine a couple months ago, but he isn’t sure which one it was.  He thinks his symptoms started a couple weeks ago, but maybe it was over a month.  There is no consistent story.

You know the one.

He is the person who didn’t ask to be sick.   He has a life, a family, friends, a community outside of anything that has to do with medicine.  He wishes he was healthy. He doesn’t have health insurance. He has had to depend on others to drive him to his appointments.

You know the one.

He is the person trying to keep track of all of this information, not knowing what is important and what is trivial; it as if he has had to take on an additional full-time job. He has waited for weeks just to see you, with the hope that you might be able to shed light on why he feels so ill.  He doesn’t really understand how to navigate the complex healthcare system.

You know the one.

He is the person the system has failed.  He was prescribed medications, but never received proper explanations. People have continued to tell him important information in English, knowing it isn’t his first or preferred language.  He is the person whom others have brushed off for years, unable to shake that label of “noncompliant” first documented ten years ago and forever, unbeknownst to him, tarnishing his chart.

You know the one

Don’t you remember being a medical student, eager to help all those who came in?

Don’t you remember those days before you were jaded by all of the negativity?

Don’t you remember that you came into medicine to help all people, yes, all people?

Now is the time when you can reclaim your life’s mission.

Now is the time when you can honestly make a big difference in someone’s life.

Now is the time when you can stop the cycle of assumptions, of prejudice, of bigotry, of apathy.

I haven’t given up on him. It’s not for me to judge. I don’t have that right. I will not let him slip through the cracks. I will not brush him off. I will not be part of that system. In fact send him my way, I’d be honored to see him — it would be nothing less, nothing less, than an absolute privilege.

You know the one.

Jennifer Chevinsky is a medical student and can be reached on Twitter @jchevinsky. She is the creator and moderator of @BioethxChat on Twitter.