Transitioning into the second year of medical school is a pivotal moment. Clinical expectations are raised and you realize you’re a quarter of the way to becoming a physician. A sense of trust prevails between patients and students at this stage. You begin to recognize your value as a health-care provider – perhaps this explains the reciprocated trust.

Setting the scene

The IWK Emergency Department is charming, with colourful walls and a cheery appearance. The cohesiveness of the staff is unique. There must be an inherent pleasantness in individuals who choose to spend their careers working with sick children. An overwhelming sense of calm, patience and reassurance was a refreshing change.

My first day at the IWK was a whirlwind experience that mimicked a Hollywood-inspired scene. A motor vehicle accident had resulted in two children requiring urgent attention. Seeing the meticulous non-verbal coordination of the trauma team was akin to watching a choreographed dance. On arrival, the patients received an algorithmic initial assessment. Care was taken to appreciate that there was a very scared child on the stretcher. The team prioritized humanizing the patient, not simply to develop rapport, but rather to show something simple – that we cared.

Feeling responsible

Patients feel secure with a stranger wearing a stethoscope, more so even than with a lifelong partner. But this dynamic is reversed in younger children, who don’t understand a physician’s role. Their solace often remains with their care-providers, who in turn hand the child to the physician to be healed. This reinforces the trustworthiness ascribed to a physician’s role, but a great responsibility of accountability comes with it.

Remembering perseverance

The resilience and bravery of even the sickest children is to me a statement of what the human spirit ought to be. An enduring, resistant and relentless desire to survive relays these overriding emotions. I remember a courageous, severely anemic pre-school girl suffering from a days-long epistaxis. Her skin was blanched and dry, her lips a smoky leaden colour. She gracefully allowed us to examine her; although she was exhausted and in extreme pain, she did her best to cooperate with our interventions. In difficult situations, I think of her perseverance and emulate her courage to surmount challenges.

Finding hope

Being unable to share good news or see an immediately gratifying response in a patient is gravely concerning for me. Medicine is still an almost relentless pursuit to find hope at times when there seems to be none. I realize that this attitude is unsustainable. As pragmatism develops with my growing clinical understanding, I will ensure the great responsibility owed to my patients and the associated naiveté will never wane. The hidden curriculum is usually discussed with negative connotations. My experience in the IWK illustrates how the hidden curriculum can teach students to model overarching empathy and relay the warm art of medicine.

Author Yaeesh Sardiwalla is a second-year student at Dalhousie Medical School.