Wednesday, May 4, 2011

Start of 3rd year clerkship

Yesterday was my first day of 3rd year clerkship. I'm starting on internal medicine. An orientation called for 7am turned out to be sitting in on morning rounds before being assigned to teams and sent on our merry way. From the first moment, we were thrown in head first. Besides being pimped about current US health economics, I was asked to conduct a focused physical exam (on a real patient!) and to write out my first H&P.

One of the more important lessons from yesterday was about the value in listening to patients and their families. When I was sent back into a room to glean a bit of missed information, the wife pulled me aside with a concerned look on her face. She wanted to reiterate her fears over the prescribed medication. She felt like "the doctor who had just been in" (the attending) hadn't taken the time to listen to her and didn't care what her opinion was. While I was in no authority to give her answers, simply listening seemed to do the trick. I took the time to hear what she was saying, to tell the family that I would find out the answers, to actually inquire about the information from my attending, and then to report back to the family.

Empathy is not really taught in medical school. Taking the time to sit with a family and listen to their concerns without interruption isn't easy in the fast paced and over taxed world of hospital medicine. Humility of saying "I don't know but I will find out" doesn't come easy to us type A professionals. Yet, after a single day of clerkship, I have learned that being empathic, humble, and truly listening will be a huge part of the rest of medical school and needs to continue over my coming career.

4 comments:

Sarah Glenn said...

When I had to visit the ED a while back, the student was the person who spoke to me the longest. He even came back to ask me what the residents had decided to do. Considering how busy it was that night, it was nice to have someone keeping track of me! :)

Solitary Diner said...

Internal medicine likes to throw people into the fire from the very beginning! I'm supervising the brand new residents for the first time, and it's interesting to watch them trying to rapidly adjust to the demands of the internal medicine ward. I'm glad you're learning empathy early - it's something that far too many people in medicine forget about.

medaholic said...

During my IM rotation, I had an attending that had 3 rules. 1) Take care of patients - he wanted us to spend as much time with them, talk to them, examine them, etc. He would help us get some paperwork moving, but his belief was that you will learn the most spending time with patients and not in a classroom teaching.
2) Call for help when needed
3) Do your dictations - He had done dictations for the last 15 years for other people, he was going to be pretty upset if he had to do a dictation for someone on the team.

mexaboy said...

OR they will eat you alive. Some common sense is needed. I actually have a large repertoire of responses and attitudes, from arrogant know-it-all to humble and compassionate, depending on who's in frot of me. Sometimes it backfires, but usually I get it right...