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Pediatric Community Advocacy Rotation – Learning from a Patient’s Perspective


“You never really know a man until you stand in his shoes and walk around in them.” – To Kill A Mockingbird

It’s 1:50 pm on a busy Monday afternoon clinic and my 1:15 pm appointment has just arrived 35 minutes late. As I write my notes, I glance out the window and see that it is raining. I begin to review the patient’s chart noting that this child has had several missed appointments in the past.

This scenario is not uncommon and there are MANY reasons for it. Over the past month on my community advocacy rotation, the hardships many families face in Indianapolis have been revealed in a new way. My understanding of the vignette above has been expanded as has my knowledge of the lack of adequate public transportation.

During this rotation, we were challenged to ride the IndyGo bus transit system. We were instructed to arrive at a destination by bus that would normally be just 7-10 minutes away by car. Initially when planning ahead I got on my computer and searched the bus routes and tried to buy a ticket. I learned that if I wanted to buy a bus ticket in advance online, I would have to order it 10 days in advance! My only option was to find exact change to ride the bus the next day. I marked my route, which unfortunately had two stops, some walking in between stops, and would take approximately 45 minutes. When I arrived at my bus stop that morning, I checked the bus route on my phone and noticed there was a 15 minute delay and I would arrive late if I continued on the current route. Instead I decided to walk several blocks up the street to another bus stop to take a different route. It was actually a difficult bus stop to find and the map didn’t quite match the destination. Luckily, I made the stop and proceeded to my destination. Despite leaving an hour ahead of time for a distance covered in 10 minutes by car, I barely made it on time. While riding on the bus, I talked with another passenger about the best stop to exit. She then shared with me that in order to get to an appointment she spent nearly 3 hours on the bus to go a distance of about 9 miles.

As I reflected on this experience I considered the many bumps in the road, which our patients’ families may experience. What if exact change is not available (especially enough to bring several children along)? Is it safe to walk along these roads to the bus stops with children? If it rains, how would I keep dry as there are no shelters to stand underneath at the bus stops. What if I didn’t have access to the internet from my phone to help me navigate to the stops or see the delay in transit? What if I just don’t have an entire afternoon to dedicate to transportation to and from the doctors office? Many of these questions I have never had to face because life didn’t deal me the same cards as some of the families that I see in clinic. I am blessed to have the luxury of reliable transportation.

The next time my patient arrives late I will hopefully remember this learning experience and be more understanding.

The views expressed in this content represent the perspective and opinions of the author and may or may not represent the position of Indiana University School of Medicine.
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Andrea Aguilera, M.D.

Andrea Aguilera is a 2nd year pediatric resident at IU School of Medicine. She graduated from Florida State University with a B.S. in Food and Nutrition Sciences. She then went on to the University of Florida where she completed her medical degree , graduating with honors in humanities and AOA. She has a passion for the arts in medicine, avidly paints and participates in the PedsinReflection blog. After graduation, she plans to stay a part of the IU family as pediatric chief resident.