Doctoring

There are many aspects to our medical education. Besides hours of lecture, labs, and clinical skills, we have a class called “doctoring”. Basically it’s a longitudinal course dedicated to teaching us the finer aspects of what it means to be a doctor – communicating with the patient, building a relationship, being open-minded, and caring for the patient. It’s about all the things having to do with being a doctor that involves flowers and rose petals. Admittedly, it’s not really one of my favorite classes.

Every week they bring in professional actors (damn good ones, I’d say) to play patients coming in to see us. It’s then that we get to take turns practicing our interviewing and communication skills.

This week, I was up to bat. A small, middle-aged lady came in looking pretty disheveled and solemn. Although her main concern was chronic fatigue, I soon found out that she was homeless with two children, living out of her car. She described her life to me; about how she would take her kids to the beach or the mall so they could have some enjoyment in life and about how hard it was to sleep at night in a freezing cold car. At one point, she even began to tear. The depth of the situation really drew me in and halfway into the interview, I forgot I was interviewing in front of nine other people. It felt like it was just me and patient.

After the 20-minute session, I escorted her out and went back to my seat. I didn’t really have a feel for what had happened or how it went. Two other med students then interviewed her for a second and third follow-up visit.

When the interviews were over, she came back in and offered her feedback. She mentioned things like awkward smiles that made her feel uncomfortable or feeling like the doctor wasn’t listening because she had to repeat herself. When she came to me, to my surprise, she didn’t have anything negative to say. She mentioned subtleties such as my unwavering eye contact, the way I listened as if we were the only ones in the room, and my tone and body language that showed I understood her pain. When the instructor asked the key question, “Did you feel cared for?”, she said, “Yes, in the first interview.”

If you know me, I’m not a touchy-feeling guy. I want to be a surgeon that cuts people up, has minimal contact with conscious patients, and saves lives through action rather than “talking it out”. Four years ago, I would never imagine myself as a someone’s confidant or a person that was sensitive to things like feelings and emotions. Today, I felt like I was able to build a relationship with a stranger and provide something more than just a differential diagnosis. What’s changed? It’s hard to say. But maybe there’s more to being a doctor than blood, guts, and glory.