Narrated by Zhang He-xiang
Compiled by Cai Jia-qi
Translated by Wu Hsiao-ting
Photo by Li Bai-shi
The suffering of a young doctor’s very first patient became a wake-up call, teaching him the true responsibility of caring for lives.
Just over seven years ago, I began my internship at a hospital in southern Taiwan. My very first patient was a 70-year-old man suffering from liver cirrhosis, complicated by both liver and kidney failure. As part of his treatment, he was placed on vasoconstrictors.
During my rounds, I checked his limbs, listened to his chest, and palpated his abdomen. As far as I knew, everything was proceeding exactly as it should. I felt in control.
That confidence was soon shattered. On the third day, a senior resident turned to me, her voice sharp, and said, “Do you actually know the side effects of this drug? Did you examine all of the patient’s skin?”
I felt a surge of defensiveness. I had checked on him every day—why was she reprimanding me? Still, I went to the patient’s bedside and asked him to undress. The sight that I saw when he disrobed struck me like a physical blow.
The skin across his groin and genitals was blackened and ulcerated. Only then did he confess that it had been painful to urinate for days; he had been too embarrassed to mention discomfort in such a private area.
Very quickly, the patient’s condition grew worse. Even after we stopped the medication, the necrosis continued to spread down his legs. His family ultimately decided to stop aggressive treatment, and he passed away soon after.
I was overwhelmed with guilt. I realized I had not been thorough enough while doing my rounds. I believed I was being attentive, yet my lack of true vigilance led to devastating consequences. The memory of his suffering became a painful wake-up call.
The transition from being a medical student—where my work largely centered on assignments and reports—to frontline clinical practice marked a shift in what mattered most. My role was no longer just to fulfill a list of duties or prove to my superiors that I had done my job. What mattered most was whether I had recognized a patient’s suffering in time, identified the cause, and relieved their pain at the bedside.
Simply put, a physician’s primary responsibility is to the patient. True respect is earned only when a patient’s pain is alleviated and their family’s anxiety is eased. This man taught me, at the cost of his own life, that in medicine, we must always stay ahead of the disease. We are the ones who must pull the brake on that runaway train before it crashes into the mountainside.
Next month, I will be promoted to an attending physician in the Department of Internal Medicine at Hualien Tzu Chi Hospital. As I take on this greater responsibility for human lives, the alarm bell from that elderly man still echoes within me as vividly as it did then. I carry that lesson—learned through blood and tears—with me as I continue my journey caring for patients in eastern Taiwan.
