By: Charlie Fencil

I noticed the cut to his lip. It started at his jaw and ran like a small red river across the corner of his mouth. He cradled his left hand like it was a small animal. One he was trying to keep safe and warm. I asked him what had happened and the story began to unfold.

He had been at home with his little brother, a friend, mom, and stepfather. It started when his stepfather threatened his little brother. An argument began, words were exchanged, and after a little while my patient retreated to his room. He told his friend it was time to go. When he was about to leave his stepfather stepped into the room and threw him to the ground. He got on top of him and started to punch. His closed fist struck my patient in the face again and again. His friend tried to pull him off, but he couldn’t. After a period of time my patient escaped and made his way for the door with his little brother. With the door almost open, the stepfather ran up and slammed it shut. My patient’s hand, like a misthrown ball through a neighbor’s window, broke through the glass of the door. His story stopped here. He did not tell me how he got to the emergency room. He didn’t want to talk to anymore. He just wanted his hand checked out. I could see the fear in his eyes, and I didn’t want to push the issue. I check out his hand and his mouth the best I could. After I was done I thanked him, and went to give my report to the doctor.

I barely remember being sixteen. The only things that remain are vague memories of freedoms building and of racing around the world for the first time. The warm home I went to at night and the family that made sure I ate before I went to bed. I could not put myself in my patient’s situation. I could not fathom the fear, the loneliness, and the pain of sitting alone in a hospital room with fresh scars from your family. I knew we had to call child services, but that did not address the underlying problems that my patient faces every day. It is a small Band-Aid to put in place to help hold together the fibers of his life until he reaches eighteen. I am not even sure child services can help him to escape from the repeated assaults on his body. In that moment I felt the power of the short white coat draped over my shoulders disappear.

I do not yet know the limit to our ability to help others. I cannot put into place my future role as a physician or a healer. Where does medicine stop and the world outside take over? An experience like this shatters my faith in the power of a white coat, but also inspires me to explore its boundaries. The ability to heal extends far outside of the ability to cast a broken hand or clean a cut to the mouth. It extends into the personhood of those in our care. I am learning that to find the boundaries of medicine one has to struggle with the paradox of both letting go and jumping in headfirst. We have to be content to heal what is in front of us and rely on others to help in aspects that we cannot. However, we must also be bold enough to jump headfirst into a problem that is outside of our medications and procedures. We must learn to navigate the rough waters of poverty, abuse, and addiction that afflict many of our patients’ lives.