Friday, April 6, 2012

The importance of knowing your patient.

Life has a funny habit, when you think you're smooth coasting, no one thinks about the potential sudden turns in that road of life. For me I guess this is how I've grown as a person. I think I've lived a lot of life, probably more than a lot of people my age. As a medical student I see so many of my peers who have just coasted, never had a bump in the road, a sudden turn. I won't say it angers me, but I almost wish that some of my peers had more experience so they appreciated where they are more. It's hard for me to imagine at the age of 24-30 how some of these people never struggled. Sure they know what it means to work hard, to get a good grade, but there's so many people that have had their parents solve every little problem.

I would never be the one to hate on someone else just because they have advantages given to them all their life, that's not the point of why I am writing. I think the point is that no matter what you're situation is, don't take it for granted. Just because you have money today, doesn't mean you will tomorrow for example. As a doctor this has numerous implications. And I guess I am just learning that for myself now. My father passed away recently, and I guess what I would like to do is write about what I am learning about myself, how it can make people better clinicians in the future.

I've had a couple moments in this year that I can look back on and realize how far I've come and how much I've changed. One of my prior posts talks about a lady I took a history from. She was told that she had 6 months to live or less the day I interviewed her, a detail that I didn't know until I was walking out the door and she told me. I went through a a whole two hour history without knowing that, thus completely insensitive and unaware of her emotional state. I blame my tutor for pairing me with this patient because I feel that this was highly inappropriate to pair a medical student with someone who just got that type of news, but I also blame myself for not picking up on this sooner. As the questions rolled on, I asked her about her sisters, one of which died recently. She got very emotional, and looking back on this, I was very insensitive to her loss, yet at that time I couldn't appreciate why. The reason is I never experienced a loss like that in my life until now. And this is what's contrasts the doctor fresh out of medical school and the doctor 30 years out. 

I have several friends who have the ability to really empathize with people who had a loss. In my naivety I never really appreciated what this meant. And I guess I would have to say that my peers have the ability to truly empathize with patients in this respect have a gift, because in my case it took a horrible experience in my own life to be able to add this dimension to my doctoring abilities. The doctor 30 years out, has experienced loss and multiple challenges to that otherwise smooth road of life. He is able to feel the emotions of his patient because the same things have happened to him, and this is fundamental to building a successful relationship with your patient. 

I think the important message is that you don't have to experience loss to empathize with someone, however you do have to see it from their perspective which seems at first glance relatively easy, but it's not. The next time you hear a patient say their sibling suddenly died, pause, take a moment to think about what this really means. Imagine if you have a sibling, and what life would be like without that person. All the memories you ever had, end on that day, and you have to keep those memories. This is just a small example of what I mean, but these are the thoughts that you're patient is thinking constantly, and this is what you must be aware of, because it will change the way you approach your patient, and expand your abilities to be a great doctor. Really try to put your mind into your patients head and you will see your clinical skills grow exponentially.


  1. I am about to enter clerkship now and have been thinking on these lines. I've heard from some friends who are about to finish school that the patient load in the government hospitals that we're assigned to is so much that one gets desensitized to everything and starts functioning like a machine. I don't want to be like that at all. It was extremely satisfying to read your thoughts as they are exactly like what I've been thinking all this time readying myself to start clerkship.

  2. You're correct but I don't think its just a phenomenon seen in socialized medicine. No matter where you go, whether it be some far off country or the states, doctors are overworked and the same effect can sensitize anyone in that situation.