Pupil and Teacher

The new student, obviously nervous, arrived at the clinic that Monday morning. He had had some previous medical experience during his years of military service. As a hospital corpsman, he had shouldered several independent duty assignments. Although he knew something about medicine, he was acutely aware of how much he didn’t know.

The doctor at the inner city clinic had only recently taken the position. He was relatively young himself, having completed his own medical training within the previous five years. After fulfilling his two-year military obligation, this doctor joined a fledgling private practice, only to find the night call overwhelming. Clinic patients were serviced through the local emergency room after hours. This arrangement suited the young doctor much better.

It didn’t take long for the doctor to determine the student’s level of competency. He gave the student free range to evaluate patients in the clinic. They discussed each patient afterwards; the doctor co-signed every chart.

Under the doctor’s tutelage, the student learned office gynecology, pediatrics, psychiatry and adult medicine. Beneath the doctor’s watchful eye, the student performed minor surgical procedures. Every Tuesday morning the two clinicians—doctor and student—would drive to the local hospital for the weekly grand rounds presentation and have lunch together afterwards in the cafeteria.

During one of these weekly sojourns, the doctor, whose hobby was photography, pointed out two wayward youths lounging against a large granite headstone in the local cemetery. “If I had my camera,” he said, “I’d capture that photo — and call it Waiting.” They both laughed at this remark as they drove to the hospital.

One day the student developed an abscess on his arm. The doctor lanced it, drained the infection, and gave the student a short course of antibiotics gleaned from samples provided by a pharmaceutical representative. Some time later the doctor asked the student to remove a small skin growth from his side; the surgical procedure went well.

The student was there the day that the doctor discovered a mass in his own neck. At the doctor’s request, the student felt the lump and gave his opinion. The student was also there when the biopsy results came back showing Reed-Sternberg cells, the sine qua non of Hodgkin’s lymphoma.

Over the following months the student shouldered more responsibility for care of the clinic patients while the doctor underwent radiation treatments for the cancer. Other doctors were contracted to cover his hours and to supervise the student.

Eventually, the cancer went into remission and the doctor was able to return to work. When the student graduated from his program, the doctor took a voluntary reduction in salary to enable the clinic to hire the student as an employee. The former student continued to work with the doctor for the next two years before moving on to pursue further training in a postgraduate program in another state.

The two colleagues managed to keep in touch over the years. They published a series of pieces in an online journal devoted to the medical humanities. The former student provided the text; the doctor contributed complementary photographs. Together they made a good match.

Then one day the doctor’s lymphoma recurred.

Not long ago the same student, now a seasoned clinician, opened a plain white business envelope to find an obituary clipping that bore a black and white photograph of the doctor who had mentored him into medicine three decades before.

Quietly, the former student read through the text. Afterwards, as he stared out through the window in his office to the stately pines silhouetted against the late-afternoon sky, he recalled the words of the great Canadian physician and humanitarian teacher Sir William Osler:

“The pupil and the teacher working together on the same lines, one a little ahead of the other.”

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