Bioethical Inquiry (2015) 12:85–86 DOI 10.1007/s11673-015-9630-z
CRITICAL PERSPECTIVES
Essay: My Own Feet Natalie Cassell
Received: 20 June 2014 / Accepted: 14 December 2014 / Published online: 25 February 2015 # Journal of Bioethical Inquiry Pty Ltd. 2015
Abstract A medical student reflection on humbling compassion through giving and receiving care in the context of global health. Keywords Global health . Infection . Physician as patient . Compassion . Medical student . Reflection
There is a scene that comes to my mind in moments of quiet, in moments of daydreams, in glimpses when I talk to patients and when I lie down and close my eyes to sleep. My thoughts come swirling up in a spout of memories and visions, bringing with them strong emotions that keep me awake and thinking. Not too long ago, I sat down to eat with some fellow medical students, and we almost immediately started into what experiences we recently had around the hospital and clinics. On her turn, one of my friends described her repulsion at many of her patients’ feet, describing one particular interaction with extremely This essay is a non-peer reviewed republication of an awardwinning entry submitted to the 2013 Consortium of Universities for Global Health contest. This essay also appears in the forthcoming publication Reflections in Global Health: An Anthology (2nd edition), edited by T. Bui, J. Evert, V. McCarthy, I. Asokan, A. Mehta, K. Miller, C. Tsai, and S. Wen and published by the Global Health Collaborations Press. N. Cassell (*) Baylor College of Medicine, One Baylor Plaza, BCM 320, Houston, Texas 77030, USA e-mail: [email protected]
unhygienic and poorly cared for feet that she had to manipulate in her examination of the patient. And as she spoke, assuring us she dutifully continued her exam without outward signs of disgust, I could feel the solemnity slip down over my face once more as my thoughts drifted to my own feet. In my first month in the village, my new home, I became sick. Being sick away from home is more than unpleasant but being sick in a foreign country—when you barely speak the language, have no friends, in sweltering heat with no relief in sight—is frightening. I had an infection. I was feverish, my ankles were ulcerated, and my feet were swollen and painful. The doctor in the capital, a several days’ bus ride away, repeated her instructions thick with accent from a distant world away: continue to bathe my feet in salt water in one of those multipurpose, ubiquitous plastic basins. My water supply was grossly dirty and even boiling it was dubious: It was probably contributing to my infection. The cholera tents were visible at the hospital as the rainy season continued, and I pushed hypochondriacal notions of dreadful illnesses to the back of my mind. I tried to carry on. A young man offered to show me how to make the first of many dreadful trips into the city to run errands. This ride was more painful than any other I remember. We waited for the minibus to fill over capacity in oppressive heat to make a five-plus-hour jarring voyage of mostly unpaved road with no stops. My legs were unbelievably painful as I tried to disembark from our minibus in the city after sitting upright for so long, and I was unable to run any of my errands in the city. Previously determined to stay stoic, I broke down crying
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as we arrived at the young man’s family apartment, where all I wished was to be back in my own home and not have to act the part of foreigner and guest, a sometimes grueling expectation. I was fighting back tears in a small third-world city apartment with strangers and a young man whom I had known, apart from the long bus ride, for a matter of minutes. And then it happened: He began to take care of me. I had been cared for since my arrival but never at a moment of vulnerability such as this. Without hesitation, he fetched and boiled water and gently took off my dusty shoes as I cringed in pain. He peeled off my dirty socks and began to wash my feet in hot water and salt. I did not know this man and he was washing my dirty, infected, painful feet. I was grateful. As I look back I can’t help but feel absolutely in debt to such a show of humility, compassion, and service.
Bioethical Inquiry (2015) 12:85–86
I was helped a countless number of times during my stay in that country without question, and the cumulative effect was to create in me a dedication to returning the favor. But in particular, having my repulsive, dirty feet washed by practically a stranger has played over and over in my head, reminding me of my dedication to service as a physician, to global health, and to communities at home and abroad like those I visited. I have yet to be able to run through this story without tears welling with gratitude and shame—shame at my unworthiness in receiving such generosity, care, and compassion throughout my stay. Hopefully, I can earn the kindness I received in that country and repay them through my service as a physician. And whenever my mind flinches when dealing with the ugly side of medicine, I hope I can remember that once, when I couldn’t, a stranger washed my feet.
CRITICAL PERSPECTIVES
Essay: My Own Feet Natalie Cassell
Received: 20 June 2014 / Accepted: 14 December 2014 / Published online: 25 February 2015 # Journal of Bioethical Inquiry Pty Ltd. 2015
Abstract A medical student reflection on humbling compassion through giving and receiving care in the context of global health. Keywords Global health . Infection . Physician as patient . Compassion . Medical student . Reflection
There is a scene that comes to my mind in moments of quiet, in moments of daydreams, in glimpses when I talk to patients and when I lie down and close my eyes to sleep. My thoughts come swirling up in a spout of memories and visions, bringing with them strong emotions that keep me awake and thinking. Not too long ago, I sat down to eat with some fellow medical students, and we almost immediately started into what experiences we recently had around the hospital and clinics. On her turn, one of my friends described her repulsion at many of her patients’ feet, describing one particular interaction with extremely This essay is a non-peer reviewed republication of an awardwinning entry submitted to the 2013 Consortium of Universities for Global Health contest. This essay also appears in the forthcoming publication Reflections in Global Health: An Anthology (2nd edition), edited by T. Bui, J. Evert, V. McCarthy, I. Asokan, A. Mehta, K. Miller, C. Tsai, and S. Wen and published by the Global Health Collaborations Press. N. Cassell (*) Baylor College of Medicine, One Baylor Plaza, BCM 320, Houston, Texas 77030, USA e-mail: [email protected]
unhygienic and poorly cared for feet that she had to manipulate in her examination of the patient. And as she spoke, assuring us she dutifully continued her exam without outward signs of disgust, I could feel the solemnity slip down over my face once more as my thoughts drifted to my own feet. In my first month in the village, my new home, I became sick. Being sick away from home is more than unpleasant but being sick in a foreign country—when you barely speak the language, have no friends, in sweltering heat with no relief in sight—is frightening. I had an infection. I was feverish, my ankles were ulcerated, and my feet were swollen and painful. The doctor in the capital, a several days’ bus ride away, repeated her instructions thick with accent from a distant world away: continue to bathe my feet in salt water in one of those multipurpose, ubiquitous plastic basins. My water supply was grossly dirty and even boiling it was dubious: It was probably contributing to my infection. The cholera tents were visible at the hospital as the rainy season continued, and I pushed hypochondriacal notions of dreadful illnesses to the back of my mind. I tried to carry on. A young man offered to show me how to make the first of many dreadful trips into the city to run errands. This ride was more painful than any other I remember. We waited for the minibus to fill over capacity in oppressive heat to make a five-plus-hour jarring voyage of mostly unpaved road with no stops. My legs were unbelievably painful as I tried to disembark from our minibus in the city after sitting upright for so long, and I was unable to run any of my errands in the city. Previously determined to stay stoic, I broke down crying
86
as we arrived at the young man’s family apartment, where all I wished was to be back in my own home and not have to act the part of foreigner and guest, a sometimes grueling expectation. I was fighting back tears in a small third-world city apartment with strangers and a young man whom I had known, apart from the long bus ride, for a matter of minutes. And then it happened: He began to take care of me. I had been cared for since my arrival but never at a moment of vulnerability such as this. Without hesitation, he fetched and boiled water and gently took off my dusty shoes as I cringed in pain. He peeled off my dirty socks and began to wash my feet in hot water and salt. I did not know this man and he was washing my dirty, infected, painful feet. I was grateful. As I look back I can’t help but feel absolutely in debt to such a show of humility, compassion, and service.
Bioethical Inquiry (2015) 12:85–86
I was helped a countless number of times during my stay in that country without question, and the cumulative effect was to create in me a dedication to returning the favor. But in particular, having my repulsive, dirty feet washed by practically a stranger has played over and over in my head, reminding me of my dedication to service as a physician, to global health, and to communities at home and abroad like those I visited. I have yet to be able to run through this story without tears welling with gratitude and shame—shame at my unworthiness in receiving such generosity, care, and compassion throughout my stay. Hopefully, I can earn the kindness I received in that country and repay them through my service as a physician. And whenever my mind flinches when dealing with the ugly side of medicine, I hope I can remember that once, when I couldn’t, a stranger washed my feet.
