Key Card.

During the third year of medical school, students are released into hospitals and clinics to interact with actual patients, doctors, and medical systems. On our first day as third-year medical students, my classmates and I each received a key card. It was a light shade of grey, had an uneven surface on one side, and easily slid into the sleeve that held our identification.

The hospital administration admonished: “Keep your key card in a safe place. Do not lose it.”

The key card unlocked all of the doors in the hospital. Just 24 hours prior—when I was a second-year medical student—I had to register as a hospital visitor and wait for people to guide me through the building. Now, things had completely changed.

After tapping the key card against the electronic panel outside of the trauma surgery ward, the lock on the door disengaged. I pulled the door open and inside were patients with various limbs elevated, wrapped in gauze, with metal rods and screws sticking straight out of their flesh.

The heavy doors of the intensive care units automatically swung open with the tap of my key card. The sighs of mechanical ventilators and various beeps from heart monitors greeted me. I spied silent, yawning people sitting by unconscious patients. Tubes jutted out from their slack-jawed mouths and numerous clear tubes trailed from their bodies to the IV poles towering over them.

The key card allowed me to step into the maternity ward. No one cast a wary glance at me when I peered at the rows of newborn babies in the nursery.

With that key card I learned that the entire hospital, with all of its sacred spaces, was open to me. I felt both terror and delight. Did they not know that I had no idea what to do? Couldn’t everyone sense that I did not belong there? I avoided eye contact with all other human beings and hastened my gait to assure everyone I was not loitering. I didn’t want to give anyone the impression that I was trying to take care of patients.

No one noticed. In some instances, I used my key card to open a door, took literally two steps into the area, then walked right back out again. Doctors and nurses seemed to look straight through me.

At the end of the day, I used my key card to leave the hospital through an unofficial exit. The heavy heat of the July evening immediately walloped me, along with a humbling realization: Now that my classmates and I were allowed into these sacred spaces, we had power and privilege.

Doctors often forget that patients can invite us into the sacred spaces of their lives. They share their physical and emotional vulnerabilities with us. We learn about their health, illnesses, fears, and hopes.

We, however, do not automatically receive key cards to patients’ lives when we first meet them. We can only earn these invitations through respect, professionalism, and competency. We must remember that, as with hospital key cards, we should do our best never to lose those skills.