Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Passing Tests And Failing my Family

"My book knowledge will allow me to recognize the pattern leading to a medical diagnosis, but I must also move beyond the mnemonic and to make time for the person seated in front of me."


Book knowledge about addiction offered me little to support my family members and others affected by this illness. To holistically serve, we need to take the time to connect and genuinely understand each person.

Quick judgments, heuristics, and mnemonics permeate preparation during the preclinical years of med school. Pattern recognition is encouraged and praised—but patients are people, not patterns.  


I made two decisions my last summer of undergrad—to pursue medical school and volunteer at a local needle exchange in Columbus, Ohio. Growing up in a family where addiction wasn’t just found in a textbook, I thought learning the sociological and physiological basis would give me a greater understanding of the struggles my loved ones have faced. The classes were intriguing—I memorized neurocircuitry, psychological theories, and sociological principles. I passed my exams with flying colors and got a certificate to prove my knowledge of addiction. 


While I passed my classes, if there was a grade for empathy and the treatment of my own family members with the same diagnosis as those I had been studying, I would have failed. Although I learned the mechanisms and biology of addiction, this knowledge offered me little to support the ones I loved. 



On my quest to find fulfillment, I knew I needed to reconcile the dissonance of my book knowledge and my treatment of people with addiction. It was a baptism by fire—my experience at Safe Point plunged me into the daily life of addiction counselors and harm reduction advocates. On my first day I was put to work packing cotton balls, tourniquets, cookers (vessels to cook down drugs), and needles.  


As I added items to clients’ bags, the dissonance dissipated. I grew comfortable with the environment and transitioned to work as an intervention specialist, where I conducted risk assessment interviews for our clients, provided Narcan, and taught overdose prevention. I listened to stories of clients couch surfing after their families kicked them out after relapsing and using to escape their family constantly berating them. It was through these stories that the individual experiences of each person I connected with became my guiding light for thought and action, instead of my textbook. 


Patients as people 

After a year in medical school, I think about my time with patients thus far and the ways in which I’ll conduct myself in the future. With a 15-minute timer strapped to each patient encounter will I see a constellation of needle marks, an irritated demeanor, chills and nausea as a withdraw in room five, or will I see a woman who has fought her hardest to retain her strained relationship with her husband of 25 years, has three young children who depend on their mother, and has recently been laid-off, who is coming to me as her last hope to alleviate her suffering? My book knowledge will allow me to recognize the pattern leading to a medical diagnosis, but I must also move beyond the mnemonic and to make time for the person seated in front of me. 








This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.