A medical student’s first day of clinical training started on the bus

It happened on a bus on my way to work. I got on and sat in the only available seat, which I quickly realized was next to a disheveled looking man who smelled faintly of urine and had a dry hacking cough that could be heard throughout the entire bus. He was leaning against the window and did not seem to notice me. I was less than pleased with my seating choice but did not want to stand back up and appear rude. So I turned around with my back facing the man to avoid contracting any potentially contagious disease.

I then saw on the other side of the bus a disabled boy in a wheelchair with his father, both sitting in the reserved seating area for the disabled. The boy had in his throat what looked like part of a tracheostomy tube and his father was cleaning it with a portable aspirator. I wondered what their story was. I wondered how the father had to change his life to care for his sick son. I tried to tap into my repository of medical knowledge to think up of a differential for what the son could have had. And I could not help control the rising feeling of smugness that came from my belief that as a medical student, I was probably the only person on the bus being so observant and thinking such complex medically oriented thoughts. I stretched my neck a bit to get a better view of the device because an old man with a cane had just gotten on a bus and blocked my view.

Suddenly, I heard a loud shout from right behind me. “Hey! Watch out! There’s a kid sitting there!” Before I could even react, the disheveled looking man who faintly smelled like urine and had a hacking cough sitting next to me suddenly stood up, rushed past me, and reached his hands out to support the old man with the cane.

“He blind. He didn’t know you was there,” the disheveled looking man said to the stunned father and the boy. I watched, also stunned, as he helped guide the old man with the cane to another empty seat. In the midst of my self-absorbed thinking, I had completely failed to see that the old man with the cane who was blocking my view of the boy with the tracheostomy tube was actually blind and would have accidentally fell on the boy and his father. It was the disheveled looking man sitting next to me who had recognized and reacted to the problem with such amazing speed and precision.

I learned something from that man that day. And when I become a clinician, I hope to one day be like him.

Ron Li is a medical student.

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  • Rick Pescatore

    I like how this ended up. Good stuff! Best of luck with M3.


  • Anonymous

    As a patient, I feel eminently qualified to say that Mr. Li is on his way to becoming a very good doctor.

  • William D. Strinden MD

    Good story, Ron Li.   It is easy for us to feel smug and smart.   When I was in my surgery residency we struggled with how to keep a dressing on scalp wounds.  I mean open wounds, 4cm x 5cm, being dressed open with antibacterial cream such as a burn or injury, waiting for it to clean up before a skin graft or flap.  We would dress people up like the three stooges with a toothache, or some equally inelegant dressing.  One day a  marginally controlled schizophrenic man who had a chunk of scalp knocked out of his head with a whiskey bottle  and who literally lived under the bridge returned to the clinic with a single 4×4 held in place with four snap-type bobby-pins.  What a revelation!   Among the three of us  we had 21 years of medical education and a schizophrenic who lived under a bridge instructed us on a better way to hold a dressing on a scalp wound. 

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