William Greenough, MD, Johns Hopkins University School of Medicine
As a fourth year medical student on the Bulfinch ward of the Mass General Hospital, my resident Don Newcombe always spent a few minutes every evening sitting with his patients in the hospital to visit with them with an open non-medical agenda to see what they wanted to talk about as a person, not as a patient.
It gave him a sense of what was really bothering them, which can so often be lost in the medical rituals of care in or outside of the hospital when the physician’s agenda is technical but the patient’s agenda is often quite different.
Laura Hanyok, MD, Johns Hopkins University School of Medicine
There are so many valuable lessons that I’ve learned from mentors. The first one that came to mind is from a colleague in my primary care practice.
Before she goes in to see a patient, she reminds herself that while this might be one of 20 people she sees in a day, she might be the only doctor that the patient sees in a year. This helps to focus her on the needs of each patient and give them her undivided attention.
I try to remember this and treat patients like they are the only patient I am seeing that day, even though they are one of many on my schedule.
What do you think?
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Michael Crocetti, MD, Johns Hopkins University School of Medicine
Over the years I’ve had different mentors across medical disciplines. Despite practicing in different fields, the most valuable lesson that I learned from them was to maintain presence during an encounter and LISTEN to the patient or parent.
Being focused and carefully listening to the patient/parent allows you to narrow down the diagnostic possibilities and be more precise in your workup and management.
This may all sound easy, but it’s really hard and it takes practice and patience. When done well the patient/parent will value the care you deliver in ways you cannot imagine, and you as the clinician are inspired to deliver the best care possible.
Margaret Chisolm, MD, Johns Hopkins University School of Medicine
When I was a medical student, in one of my clerkships I was assigned to follow a patient with schizophrenia, severely disfigured from burns, who had spent most of her life in a state psychiatric hospital. One day, I glimpsed her sitting alone on the day room sofa and sat down next to her to chat – not formally, as had been done the day before at her admission – just as two people talking. I could see she was thought-disordered and delusional, but – sitting quietly with her and listening closely – I began to understand her experiences in a more personal and moving way. After a half an hour, the attending psychiatrist stopped over to have a word. Worried that I’d violated some professional code, I was surprised and delighted when he whispered in my ear: “Don’t ever change.”
When I think of professionalism and humanism, I think of those three words: “Don’t ever change.” As Abraham Verghese has suggested, students enter medical school as caring individuals who want to help patients by connecting with them on a personal level. However, this desire gets worn down, if not away, by their medical training. Students need all of us to remind them – by words and example – to not ever lose their ability to connect with patients as individuals, and to appreciate that each patient has something important to contribute to their care and to the world we share.
The human relationship between clinician and patient will always remain of paramount importance to achieve the changes in patients’ attitudes and behavior essential to healing.
Tina Zhang, MD, Johns Hopkins University School of Medicine
The most valuable lesson I learned from my mentor is that medicine is a team sport. In order to provide clinically excellent care, it is crucial to coordinate with and work alongside nurses, pharmacists, case managers, medical assistants, and other members of the patient team.
