A patient is brought into the emergency room at the hospital suffering from a stab wound. He is a young boy of 15 years of age and states the incident was unprovoked. He states that the people who did this are people he knows, and are troublemakers. As a young woman who has worked as an emergency medical technician on an ambulance, I have in the past seen a similar patient in New York City. I think to myself how similar these acts are, and yet, how different they are treated. Here in Grenada, this young boy was bleeding in the street with his friends awaiting his mother's arrival to take him to the hospital. In New York, we are fortunate to have emergency medical technicians arrive on the scene to tend to his wounds. We have a dual response with the police department, allowing for some comfort for this young man during his time of need. It highlights some of the differences between my home country and the country I have called home for the past two years.
My mind wonders as to the emotional state of this patient. He is a young boy, in the surgery ward with adults. Why he was not placed in the pediatric department with others his own age? I worry about his mental and psychological wellbing. As a team, we asked him how he felt about what happened to him, sharing that we felt a person in a similar situation as him may feel scared or nervous about what happened. And he just shrugged his shoulders, seemingly as if it was not something he wanted to talk about, or something he had not considered.
While I understand he was at the hospital receiving appropriate medical care for his physical well-being, I worried for his psychological well-being.
I wondered if and how social work and child protective services worked in Grenada. From my personal experience working in New York, I was aware that when children are involved in assault, social workers became involved, police took statements, and the child was placed in a pediatric ward. I wondered if there had been a psychologist or social worker in the hospital, would my patient have been more willing to talk about his experience, perhaps express his fear about what happened?
That's the ideal in such situations: To be able to illicit an emotional response, address it, and then follow-up with him. Each healthcare system has its limitations, but I would like this to be so for him. I would like for him to process his experience, to talk about it with a trusted healthcare professional, and to come up with a plan if he is having uneasy feelings, to help him if he needs it. I worry that although his physical wounds will heal, the psychological ones may take longer. If they're not addressed, they can impact his further development as a young man in society.
I participated in this rotation with the hope and excitement to learn about medical procedures, post-operation protocols, etc., but I found myself more concerned about the psychological manifestations of a violent act and how this would be taken care of. I wanted to inquire more about his home life, his friends, his activities. and about him as a growing person.
In some ways, being able to spend an extended period of time with this young boy, I began to care for him and look past the medical complaints and more towards the psychological. It was surprising to me on some levels, and I am thankful I experienced it. I am thankful to have been able to speak with this young boy, and explore the culture of how assault was handled in this case. Yet, I still have questions, and will continue to be curious and explore the best ways to address the psychological wellbeing of victims of assault, to keep these things in mind as I continue my medical education, to become better at addressing it with someone who is not forward about their feelings. It is important to me to build that rapport with my patients. I am aware that as a medical student this may not always be feasible, but it is what I will continue to strive for in the future.