by Paul Nguyen

I had never seen her in my life. Her eyes darted nervously between the 3rd year student and me while he spoke to her in fluent Mandarin, ascertaining the exact location of the pain for the injection. A few rapid sentences were exchanged when she looked at me again and then in English muttered, “I want the older doctor to do it, not him.”

Sure, we had practiced hallux blocks on each other as classmates, but sticking a needle into a complete stranger was another story. I had volunteered to see this patient specifically for this reason: do something enough times and eventually you’ll get over the initial hesitation. I wanted to overcome the fear of puncturing people’s skin with a needle. There was no way to know how much pain they would feel. This pain empathy of imagining how the needle must feel going into someone’s skin was an obstacle I wanted to overcome.

You cannot win your battles if the patient does not win theirs. I needed to gain her trust.

Recognizing her hesitancy, I palpated and explained to the patient exactly what was in the vial and how it would help her pain management. I explained to her the underlying anatomy and why it was causing her pain. Last but not least, I told her exactly where I would put the needle and assured her that I had done this many times before.

The 3rd year student marked the spot and held the cold spray readily. “You need to go in as soon as I stop spraying. Do you understand?” I nodded confidently. He sprayed for 5 seconds. I pushed the needle in and met resistance. The patient let out an audible gasp. I softly reassured her and injected as I went deeper. After dispelling the entire 5 mL, we put a bandaid over the injection site. There was no bleeding as the wound had already closed up.

“That wasn’t too bad was it?” I asked with a smile. She thanked me profusely and shook my hand. All I could think about was her first initial wince and how much her demeanor had changed throughout the visit.


Every patient we interact with has a backstory, a life we do not know about, and a preconceived bias of who we are within seconds of seeing us.

When the patient trusts you and wins their own battle of judging you, it allows you to do your job more effectively and with more confidence.

If I cannot earn the patient’s trust, I have already lost my own battle.


by Paul Nguyen

School: California School of Podiatric Medicine (CSPM)



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