Students on Serving The Underserved; Week 4

Anonymous Author

Early in medical school, I remember a professor saying that she enjoyed working with 1st
and 2nd year medical students because, while still in their pre-clinical training, they had not yet
made the transition from identifying with patients to identifying with physicians. At the time,
this made only partial sense to me, but as I am on the verge of finishing my 3rd year, I am
beginning to understand her point. Throughout this year, as I have worked in a variety of
clinical settings, I have noticed myself identifying more and more as a physician than as a
patient. This is a natural process for each health professional student, but the downside of it is
that our ability to see through the eyes of our patients is dulled. As a 3rd year student, care for
the patient with congestive heart failure, asthma, COPD, sinusitis, diabetes, and a myriad of
other diseases has begun to feel routine. As a health care provider, I will diagnose the same
diseases, prescribe the same medications, and perform the same types of surgery numerous

For the patient though, these diseases, medications, and procedures are anything but
commonplace. For instance, although the dermatologist may diagnose and treat skin cancer
thousands of times during his career, it can be a life-altering and distressing experience for the
patient. The slowly building fear of a suspicious looking spot. The catch of one’s breath as the
physician agrees that this one looks bad. The strange experience of the tissue biopsy. The
waiting for the phone call. The moment when the doctor’s office calls and one’s heart seems to
skip a beat. The shock of the diagnosis of cancer. The fear of what happens next and the quiet
conversations with loved ones. The anxious waiting for the scheduled surgery. The surgical
drape being laid across your face. The sting of the lidocaine. The pressure of the blade. The pull of the sutures. The slow healing of the wound into a new scar. The joy felt when the tissue
margins are declared to be clear.

These experiences may be once in a lifetime for the patient, and each patient will
respond differently throughout the journey. As physicians, it is our job to strive for empathy
with each patient as we consider how the disease is affecting them. We must get to know them
and foster open conversation so that we may work together with them to find the treatment
plan that is best suited for their situation. There are no one-size-fits-all plans in medicine.
Patient-centered care requires that the uniqueness of each patient be appreciated and kept in
view as the plan is developed. It requires that the physician relinquish the stereotyped role as
the “captain of the ship” who unilaterally gives orders for the patient to follow. Instead, the
physician must become a steadfast guide who walks alongside her patient, lending her
expertise to help the patient sift through the latest evidence and apply it to the patient’s
unique situation.