Baby Steps

Short-ish post tonight. I’m headed into my Block 1 (of 3) exams, but I wanted to reflect a bit about my experiences these past few weeks as well as some related memories. Most striking, I think, is the notion that in order to be good physicians, we have to be good people – in all parts of our life. As a parting message at the end of his lecture, one of the physicians who spoke to the first year medical students during the first week of classes urged us to lose our tendencies to judge people, whether in our private lives or in the practice of our profession. He emphasized that it’s impossible to compartmentalize our behavior – whatever we do or however we act in one part of our life will inevitably leak into another.

This idea, of course, isn’t really surprising, but I am struck by what I hope is a wrong assumption of mine: that there might be plenty of people entering the medical profession who don’t think that they have to be good people, or better people than they currently are, in order to be good physicians. This is, of course, also assumes that people want to be good physicians, and not just physicians. My perspective on this might be overly demanding at this early stage in training, but it’s always a bit disappointing to see people choose to not fully engage the opportunities that are given to them. Not that people should be serious or intense about their medical training all the time, but I think that people should admit to themselves that they need to be better people if they want to be good doctors (and be open to taking steps in that direction, however small and seemingly insignificant).

1. During a medical school application seminar at the Office of Career Services at Harvard (where I went to college), a classmate of mine asked, “So, why do medical schools want to have their students be ‘good people’?” *jawdrop* People baffle me sometimes.

2. I’m happy to note that my community preceptor (a physician I shadow and work with to take histories and do physical exams during the first year) for my Foundations in Medicine course (a clinical skills training course) is the father of one of my best friends – I knew him before personally, and now I get to see how he works as a physician. So far, I’ve seen him in the clinic once, and my impression of his personality in social settings helped me predict exactly how he would behave in a professional setting. Socially, he’s charismatic, charming, a good listener, and he makes you feel comfortable and engaged (as though you’re the only other person in the room) when you talk to him. In the clinic, he was much the same way with his patients: he knew when to joke with them, when to be more efficient and serious, and when to be more pushy or demanding. In a sense, he knew exactly how to connect to each person, and he treated each patient as an individual rather than as a case. I sometimes wondered why some of my non-premed friends at college were so sure that someone (another college student) would make a bad doctor, but I’m at least certain that it’s quite possible to tell when someone would make a good doctor.

3. I like my classmates a lot and think that they are, for the most part, good people, but my assumptions about people in New Orleans (my hometown) being more personable and charismatic in interpersonal interactions was challenged during a small group Problem-Based Learning (PBL) session for Anatomy. In our second session, we had the opportunity to interview and interact with a Standardized Patient, someone who is trained to mimic a patient presenting with a certain set of symptoms (i.e. they need to understand a fair amount of medical cases, and many later enter medical school and become physicians). The session went great: we solved the case with time to spare, and we approached the case in a methodical, efficient manner, though our physician facilitator did most of the actual patient interaction and physical examination. When our facilitator asked us who wanted to deliver the news to and discuss treatment options with our patient (who was sitting there in the room), it was silent for a moment, and then I volunteered – if only to give myself one more opportunity to practice before interacting with real patients in this manner. After the session ended though, I was surprised that (to my knowledge) I was the only person who bothered to get up, shake the Standardized Patient’s hand, and thank her for helping/teaching us. It’s almost as though she were just a manikin or a learning tool to everyone else, which didn’t rest well with me. Perhaps it seemed awkward, but it doesn’t bode well if we can’t, even just as people and not physicians, brush away that awkwardness to reach out to someone.

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