The first time I met her, she was trying to slip through closing elevator doors. We both apologized profusely and introduced ourselves. She is Vietnamese but lives in the United States with her husband. Later I saw her in the pulmonary unit. Her mom was sick. She did not understand what was wrong with her. She told me how scared she was. “It’s not like the United States.,” she said.
The patient rooms in pulmonary easily have ten beds. Patients often lay head to foot, two patients to a bed. The room is further crowded by family members who take turns caring for their loved one. Many patients have tuberculosis. The rates of nosocomial infection is unusually high. Nothing about this hospital screams sterile and safe. “I’m scared, too,” I told her.
Over the next couple days I became more familiar with her mother’s case, and would check in daily to see how her mother was doing, chat with her about life back home or the best phở spots in Saigon. Her mother had pneumonia, complicated by chronic diseases of her liver, kidneys, heart, and entire vascular system. She was an elderly obese woman with chronic obstructive pulmonary disease and generally declining health before her admission. I looked at her X-rays, listened to her lungs and heart, and watched her ventilator settings, watched her struggle to breath. The doctors were giving her antibiotics and a bit of oxygen, but not treating any comorbidities. Having seen two patients die the previous days, I was worried but hopeful. I spoke with her daughter, prayed with her, and made sure her mother was getting excellent care.
Many times she would come to me and say, “You are an American doctor. You are studying medicine in America. You are good, I know you are. You can help my mother. You are better than the doctors here.” I reassured her the Vietnamese doctors were in fact a lot more qualified than I was, and that Sandra had reviewed the case and could not see what else to do with the limited resources. But still, her vision of us as Americans, and therefore competent, was unwavering.
Her mother’s health declined as the week passed, and so did my hope. Thursday evening, I came in to find her right big toe totally gangrenous. Her toe was charcoal black, and my eyes traced a red, edematous trail up her leg, leading to swollen blisters filled with pus settled by her knee. When her daughter asked me what I thought, it was impossible to paint a rosy picture.
The next morning, like every other morning here, locals parted like the red sea for me to ascend the stairs to the eighth floor. The locals looked at me with a mix of bewilderment, awe, and respect that the white coat no longer carries with it at home. As I walked in, I noticed the crowd of nurses and the beeping ventilator equipment. She was coding. I watched the woman watching her mother, crying and praying. I felt helpless like I had let her down. Not as though there was anything I could have done, but because I was not the great doctor she saw me as.