On one occasion in the emergency room, an elderly woman was irritated and was giving the nurses a hard time. I offered to sit with her and was initially met with both hostility and resentment. Eventually, we started chatting and his apprehension began to fade. By the end of our conversation, we were both laughing. Pulling me closer to her, she whispered that she had soiled herself before but was too embarrassed to tell anyone. Patience, persistence and open communication allowed me to determine the reason for his behavior. The solution was very simple and he finally felt comfortable enough to interact with his healthcare providers and receive the care he needed. While I can't say that our initial interaction was pleasant, it was a truly rewarding experience knowing that I was able to make this woman feel comfortable during her stay. I have experienced firsthand that working in the medical field, even in the United States, presents its challenges. As I learned in Peru, clear communication and sensitivity to the patient's specific needs are universally appreciated