2017 Hope Babette Tang Humanism in Healthcare Essay Contest

Iringa Regional Hospital, summer, 2013. It is here, close to 10,000 miles from home that I, a Bay Area native, found myself trying to navigate a city vastly different from my own. Amongst the hustle and bustle and bantering in Swahili, I spent a month trying to learn everything possible about a new culture, country, and its people. It is at the regional hospital, in the oppressive heat of July that I spent my day-to-day, shadowing physicians and seeing what differences in access to care truly look like. It is in that hospital, in the halls of the outpatient department that I first solidified what compassion, empathy, and shared humanity truly look like. And it is here that I spent a week under the watchful guidance of Dr. Smith. At this small hospital, doctors worked countless hours despite the lack of funding, tools, or means to treat their patients. Dr. Smith was one of only two female doctors at the hospital. She was strong in every sense of the word. On a daily basis she proved the prejudice of her male peers wrong by being one of the best physicians in her department. I vividly remember Dr. Smith’s fearless attitude and ability to command presence upon entering a room. One day, Dr. Smith had a little boy as her patient. The mother carefully removed the young boy from her back, as most children are carried this way when they are especially young, and laid him on the examination table. I approached the boy, as instructed by Dr. Smith, and was struck by the silence in the room. Something wasn’t right; a young boy shouldn’t be silent on an exam table, and from my experience, there would’ve likely been some commotion, as most two-year-olds like to cause a fuss when being told what to do. I went to touch the boy and he was cold; I went to find a pulse, and there was nothing. Dr. Smith repeated the steps I had done and continued listening to the mother. It was clear that the mother had no idea her son had already passed away. The mother told us that the boy had been suffering immense dehydration from diarrhea, and the mother was far from a hospital. So she placed her baby boy on her back and rode a bus for nine hours to get to the nearest hospital. The dehydration was too much for the boy, and when the mother removed him from her back, having thought he was asleep, she then learned from Dr. Smith that her son had passed on the journey to the hospital. The mother stood frozen in time upon hearing the news until finally a fit of tears and wailing escaped her. She fell to the floor sobbing in a combination of grief and disbelief. In silence, Dr. Smith inched down and sat on the floor with the mother to get on her same level. Without batting an eye she held the mother’s hand and simply listened, trying to empathize with her. Dr. Smith did her best to listen to the grieving mother’s concerns, to her heartache, to her disbelief. She listened until the mother, finally beginning to comprehend the situation, revealed that she wanted to be certain the boy made it back to their home to be buried. The mother expressed her concern as she didn’t have enough funds to ship the boy’s body back home in a coffin, as there was an increased fee on the bus. She also worried that should the boy be buried at the hospital cemetery, that in the afterlife he would be separated from his family, and those who had already departed. Dr. Smith listened and nodded, acknowledging the mother’s concerns, but still remained silent. Several minutes passed in this silence, where Dr. Smith and the mother sat on the floor. In those minutes that passed I grasped the compassion and understanding, as Dr. Smith and the mother turned from patient and doctor, to two humans who both would do everything in their power to solve the problem at hand. At last Dr. Smith rose; she had an idea. She prefaced it by stating the idea wouldn’t be desirable and would likely be very difficult for the mother, but would solve the situation at hand. The mother then rose, and with a newfound strength said she would do whatever was necessary to get her baby boy home. Then Dr. Smith, speaking in Swahili, addressed the mother with her plan, while I watched and looked for clues as to what the plan entailed. Dr. Smith walked over to the body of the boy, wrapped him in the blanket he arrived in, then helped to place him on the mother’s back. From an outsider it would appear as though nothing was wrong; there was simply a mother carrying her sleeping child. I then understood; there would be no additional fee if the boy rode home the nine hours in this manner. The mother then wiped the tears off her face, thanked Dr. Smith, and left, a mutual understanding between them. Dr. Smith then went back to her desk and finalized some paperwork, returning to her typical demeanor. She didn’t explain her actions, nor would she have to. I saw the compassion and understanding between patient and doctor, between two humans while one suffered tremendously. I saw what it meant to do everything possible for someone you cared about, and to do everything possible to help a complete stranger, simply because they, too, are human. On that day, I saw the real and genuine compassion that was shown, because Dr. Smith saw a common humanity between herself and the patient’s mother. A common humanity we all share. Name was changed to protect the right to privacy. 2017 Hope Babette Tang Humanism in Healthcare Essay Contest Each year, the Arnold P. Gold Foundation holds an essay contest to encourage medical students to reflect on their experiences and engage in narrative writing. The contest, launched in 1999 and open to any student enrolled in an accredited US/Canadian medical school, asks students to respond to a specific prompt in a 1,000-word essay. The 2017 prompt was “Compassion becomes real when we recognize our shared humanity” (Pema Chodron). —Using the quote as a reflective prompt, write an essay based on a true story or anecdote that illustrates an experience where you or a team member worked to ensure that humanism (compassionate, collaborative, scientifically excellent care) was at the core of medical practice. Almost 200 essays were submitted and reviewed by a distinguished panel of judges ranging from esteemed medical professionals to notable authors. The top 3 essays were selected along with 10 honorable mentions. Winning essays were published on the Arnold P. Gold Foundation Web site (www.gold-foundation.org) and will be published in consecutive fall issues of Academic Medicine. The contest is named for Hope Babette Tang-Goodwin, MD, who was an assistant professor of pediatrics. Her approach to medicine combined a boundless enthusiasm for her work, intellectual rigor, and deep compassion for her patients. She was an exemplar of humanism in medicine. The Arnold P. Gold Foundation, founded in 1988, is dedicated to creating the gold standard in health care—compassionate, collaborative, and scientifically excellent care—to support clinicians throughout their careers, so the humanistic passion that motivates them at the beginning of their education is sustained throughout their practice.

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