I knew before my time at Grady Hospital that I could learn a lot about someone from one personal item or one moment of that person’s life, but I never realized the emotional impact a Xerox of an insurance card in a dead man’s chart — which included the names of his family covered by the plan — could have.
Nor did I realize how much I could be troubled by the copy of a young girl’s driver’s license after reading of her extensive injuries and death. Progress notes included family visits to the injured and documented their discussions to sign patients’ “Do Not Resuscitate” orders. People showed their character by the clothes they wore when they come in to the ER, the reasons they were injured and their state of mind as they received medical care. I could not help but think to myself: Where does this person come from? Who is this person, in a fundamental way? Why was this person in this situation? What was this person thinking? How will this person recover?
Grady is an unusual place in so many ways; the world as I know it seemed upside-down once I entered its doors. Many people who come to Grady are very different from the people who surround me daily at home and at school. I am sure, for instance, that most of the people I know are insured. When walking down the street, I try to avoid eye contact with people I assume might be dangerous, but at Grady the very people I would have sidled warily past in the streets were being held down by doctors and crying for help.
Doing research at Grady made me realize that research projects — in my case, a vasopressin study — might not always work the first time. Three of us research students would stay on call rotating nights to collect vials of blood from trauma patients as they arrived at Grady. We didn’t know until near the end of our time there that our study would not turn out as we had hoped.
There is a good aspect of every failure, however: Staying at the hospital day after day made me realize how it is possible to impact medicine not only through research, but also through public health on a more national and global scale in a way that can touch the lives of more people than immediate patients. Grady, one of the most destitute hospitals in a country as wealthy as the United States, has much to teach us about a health system that fails so many millions of uninsured residents and fails to compensate for what hospitals spend on these patients. I can only hope that, in the future, I and others in the Yale community will be able to act upon these issues.