Fracture Lines
by Shreyas Banerjee
I have found that feeling helpless is intrinsic to the experience of being a medical student. As a first-year, it’s always there, that sense of powerlessness. Every time you step into the hospital or face a patient, it sits with you. You watch the upperclassmen and the doctors—how they know what to do, how they know what to say—and you feel small. Useless.
In my first year, I often came face-to-face with my inability to help. My knowledge was thin, and the circumstances too heavy to overcome. Volunteering at a free clinic made it clearer. The people who came there were the ones who couldn’t afford to see a doctor. They came in with chronic conditions that couldn’t be fixed in one visit. The regulars, those who came for follow-ups and medication refills, they kept things in perspective. They were grateful. Their energy made it feel worthwhile.
But then there were the others. The ones that gnawed at you, the ones whose suffering stirred something deeper inside—something like rage. Not at the patient, no. At the situation. The way life had put them here.
Arriving at the clinic one day, I was somewhat excited. I was still somewhat new to the clinic but after several months of volunteering consistently, this would be the first week that I would be leading my team. Teams are usually composed of a clinical student, a pre-clinical student (that’s me), and a pharmacy student if available, all volunteers, with the clinical student leading the patient interview and examination. On this particular day, the clinical student I was paired with wanted to stand back and watch—it was their first time volunteering at the clinic—so I was assigned to take point. My excitement quickly turned sour as soon as I met my first patient of the night.
I saw a man in a wheelchair. That, of course, wasn’t unusual. But then I noticed how young he was, and how physically fit he seemed. No swollen joints or atrophied limbs—nothing like the chronic conditions I’d come to expect. Something terrible had happened. His brother accompanied him, and a woman introduced herself as a victim advocate from the county prosecutor’s office. She was there to ensure proper care. I was confused—free clinics weren’t usually visited by government-appointed advocates—but I started to take the patient’s history, just as my medical school had taught me.
The story began to unfold. The man had recently crossed the border from Colombia with his young daughter, hoping for work and stability. He stayed with his brother, who had arrived a year earlier, and six other men, all roofers. He joined them, but within a month, he got tangled in wires on a client’s roof and fell. Multiple injuries. A scaphoid fracture, a subdural hematoma, a trochlear nerve impingement, facial paralysis. But worst of all—a complete spinal cord transection from T4 down. I was in the middle of my neurology unit and had just learned what that meant. I tested sensation and vibration, reluctantly confirming the findings of the surgeons, whose notes the advocate handed me. She told me they were there for wound care instructions—he had a large open wound in his sacral region—and to coordinate follow-up care.
The man hadn’t been told how to manage his conditions or what his life would be like long-term. She also explained she was taking charge of his care to ensure the company he worked for would provide workers’ compensation. They hadn’t agreed to it yet. Many companies that hired migrant workers simply refused to pay medical costs, and some even dissolved and reformed under a new name to avoid liability. After all, they shouldn’t have hired an undocumented immigrant in the first place.
I stepped outside and took a breath, trying to clear my head. The weight of it all hit me. A man who had come here with hope, trying to build a better life for his daughter, now broken and helpless. He would never walk again, never care for himself, let alone his child. The anger rose in me then. How could this happen? Who had hired him and then left him like this? Did they think they could just use him and throw him away? And I knew they could. They probably would. The helplessness came back, stronger than before. It wasn’t just that I couldn’t help him. No one could. His life had been twisted by desperation, and now crushed by indifference. He was one of the many this country discards when they’re no longer of use.
What could I do? To fix a life is a hard thing for anyone, especially a first-year student. My training, in medicine or in life, taught me to see every problem as something to be solved. I thought if I learned enough, I could handle anything. But sometimes, even with all the knowledge in the world, there are things you can’t fix. I always knew this. But I didn’t understand it until then. And still, my helplessness was nothing next to his.
I stood there, the cold truth pressing down on my chest. The sun was setting outside, casting long shadows through the clinic's windows. I thought of the man, his broken body, his daughter waiting somewhere for a father who could no longer stand, no longer carry her on his shoulders. The advocate’s voice, steady and practiced, echoed in my mind, outlining all the ways the system had failed him.
I took another breath, long and slow, and stepped back inside. The man was waiting, his eyes calm but distant, the kind of calm that comes after too much pain. His brother stood next to him, hands in his pockets, as if holding in all the anger I had felt outside. The man glanced at me, a flicker of hope crossing his face, expecting me to do something, to say something. Maybe reassurance, maybe answers.
I could offer neither. I took his hand, not to heal but to hold. And we faced the silence together.
Shreyas Banerjee is a third-year medical student at the UTCOMLS
