When Hurricane Harvey swept through Texas, devastating millions of people, I was lucky to be in an area of Houston where the flooding did nothing more than confine me to my apartment for a few days. It hurt to see so many people suffering after reading the news and social media posts about people losing their homes, many of their belongings, and in some cases, their lives. As the flooding calmed down and the roads became safe to drive, I knew that I could not just go back into my daily routine.
As a medical student, I responded to a call for help from physicians staffing a makeshift medical triage unit at the NRG Center, one of Houston’s largest public shelters open to thousands of families displaced by the hurricane. I worked alongside other nurses, doctors, and health professionals from several academic centers and private practices in and around the Houston area – all working pro bono. Although I have had opportunities to practice my clinical skills under the supervision of preceptors as a part of my preclinical training, I felt nervous but excited to work with more autonomy in a fast-paced environment. Unlike my formal training, where I discussed 1 to 2 patients with a preceptor over the course of a few hours, I was able to see at least 20 to 30 patients for several hours in the unit. I interviewed patients to elicit their medical history, checked vital signs and blood glucose levels, performed physical exams, presented and developed action plans with attending physicians, and worked with pharmacists to help dispense medications.
Patients needed care for a variety of reasons, ranging from being unable to access outpatient clinics for their chronic conditions to acute trauma from injuries due to the flooding. One patient told me about not being able to take her blood pressure and diabetes medications for a few days after running out of her home when the flood water finally breached its doors. She had an appointment to refill her medications, but it was canceled because the clinic she was supposed to go to was flooded in as well. So, when another medical student and I checked her vital signs and blood glucose levels, we saw a significantly elevated blood pressure that could lead to other medical complications, as well as an abnormally high blood glucose level on the beeping glucometer.
Another patient had pain and swelling that had developed in her legs after walking for several miles in the cold rain, trying to seek refuge from the torrential storms that took her home and belongings. She also had a minor fall that cut her ear, causing her to lose an earring after becoming tired from trudging through flood waters for hours before being rescued. By the time we saw her, she was no longer shivering from hypothermia and had eaten, but she was clearly stressed about the uncertainty of how long she had to stay in the shelter and not knowing where to go next.
The plan for these patients was relatively simple. For the first patient, refill diabetes and blood pressure medication prescriptions and have them come back in a few hours to check blood pressure and blood glucose levels. For the second patient, give over-the-counter pain medications, cover the cut on her ear with Neosporin and a bandage, let her rest, and give her reassurance. If I had seen these patients as a part of my formal preclinical training, I may have perceived these appointments as routine and unexciting. However, the underlying stress caused by the consequences of the hurricane made my interactions with these patients much more meaningful.
Working in the medical triage unit renewed my appreciation for why I wanted to become a physician in the first place: to help people through addressing their health care needs during some of the most intimate and trying times in their lives. Clinic operations were hectic and hinged upon paperwork being put into Sharpie-marked cardboard boxes for follow-up care, and the resources at the unit were very limited, only allowing us to address some of patients’ most basic medical needs. However, the shared camaraderie exhibited by my newly acquainted colleagues quelled any temporary confusion or frustration I may have had. In the unit, I felt a collective aura of positive energy driven by people with years of accumulated medical knowledge and training come together to help others in less fortunate circumstances. Although I am warned about the feelings of burnout I will inevitably experience during the long, arduous journey that is medical training, I hope to look back on this experience as a reminder that even the most mundane aspects of what I am learning will have a meaningful impact on my future patients, even if I have limited capacities in what I can provide.
Ryan Jacobs is a medical student and can be reached on Twitter @rjacobs147.
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