Though I was born in the United States, I grew up very Chinese.  Honor and respect for elders was one of the highest values in my family, as it is in the culture at large.  It would never occur to me to be on a first name basis with anyone in my parents’ or grandparents’ generation; they were all uncles, aunts, and surrogate grandparents.  Teachers, as well, always had a title.  In the presence of these zhang bei (senior generation), I would sit or stand up straight, pay attention, and never interrupt.  So it feels Humbling to find myself friends—equals!?—with so many of my elders—

Joe, my 7^th grade math teacher,

Dawn, my 7^th grade English teacher,

Kathy, Joe’s wife and the music director for the 8^th grade play,

Barbara, my 9^th grade geometry teacher and freshman volleyball coach,

Lisa and Jerry, my varsity volleyball coach and her husband, one of the football coaches,

Mary and Dan, my confirmation sponsors in college, pastoral associate and pediatrician, respectively, and

Keith, my clinic preceptor intern year.

I always wondered, what did they see in me, so young, naïve, and ignorant, that would make them want to know me as a friend?  Then about ten years ago I found myself befriending students and other ‘young people.’  I gradually realized the rewards of the exchange—new perspective, fresh ideas—connection across generations, cultures, experiences.  I felt a sense of mutual admiration and understanding, despite the age gap—an appreciation that bridged the separateness.

Somehow this reminds me of a morning I spent volunteering in a free clinic a few years ago.  As per usual, patients filled the waiting room and clinic workflow bore no resemblance to anything efficient or modern.  But the atmosphere pulsed with purpose and kindness.  First and second year medical students helped run this clinic, relishing the chance to hone their history taking and physical exam skills.  They saw the patients first, synthesized all relevant data, and presented a summary to one of a few attending physicians staffing the clinic that day.  After some discussion on pathophysiology and care plan, the attending led the team of students back to the exam room to finish the encounter.  If you have ever been a patient at a teaching hospital, it’s much like that, only much slower and often with profound technical barriers and almost no support.

That morning I walked in with my team to greet an elderly Pakistani man for follow up of his blood pressure and diabetes.  I knew he had been waiting a long time.  It was almost noon and he had not eaten all day, in preparation for fasting labs he knew he needed to have drawn.  Upon greeting him, I automatically apologized for the wait, put my hands together, and bowed slightly, while I thanked him for his patience.  I felt bad about the whole situation, and I wanted his pardon.  His face lit up and he immediately turned to the students and said something like, “See?  That is how you treat an old man!”  He was not angry or crotchety in any way.  He seemed honestly and happily surprised to be treated with Honor and respect—as if he suddenly felt seen and appreciated for who he was—a member of an older, wiser generation than all of us.

In Pakistan this gentleman had been a middle- to upper-class professional.  Here in the US his resources were drastically curtailed, such that he had no health insurance and depended on the free clinic to get treatment for his conditions.  I wonder if he was used to feeling like just another immigrant patient in a busy, understaffed clinic where there were few occasions for others to ask about and listen to his story.  Since I was a periodic volunteer, I had that chance.  I get to choose when I am willing to donate my time and energy to the free clinic—everything I do there is on my own terms.  The patients there have no such choices.  If they want care, they have to show up—early—on the day the clinic is open, regardless of what else is going on in their lives.  There are no appointments, and almost no continuity with providers.  It’s a completely different world from where I make my living, on the Gold Coast of Chicago.

I am Humbled by the opportunity to meet people from all walks of life.  Students arrive at medical school from diverse backgrounds.  Patients may hail from all corners of the world, many having come through experiences I can scarcely imagine.  It is my Honor to care for all of them, and I wish to maintain this perspective of respectful service.  I have those who support, teach, and guide me in life—older and younger.  So it is my privilege to give back—to offer my own knowledge, expertise, and maybe sometimes wisdom—and help make a positive difference in people’s lives.  I can’t remember exactly, but I think I said something to this effect to the medical students that day.

Physicians have power by default and design in the medical setting.  We can wield that power with more grace and efficacy when we remember Humility, and Honor our patients as whole, rather than broken or defective.  Be they students, friends, political opponents (yeah, stuck that in there), teachers, or patients, there is always something to learn from someone else’s perspective.  Cultivating the Humble and Honoring perspective, when I can muster it, makes all of my relationships infinitely richer.