Friends,
I had to write about the art of medicine to complete the semester. This is not how I feel that things have to be, but I think it's how things are. I chose to go this MD/PhD thing for the potential, and how much good I can do, and that I can always work to be better. One day I'll write about all the great things. One day...
The art of medicine might be applied when discovering methods of achieving patient compliance. Patient compliance incorporates skills such as listening and addressing the concerns of the people we treat. A positive relationship based on a common goal and a mutual appreciation will be an effective tool in achieving patient compliance. This might require us to exhibit benevolence and clemency. The humanity required to do this is not a focus of our experience in medical school and such experience outside of medical school is not encouraged.
The most common complaint I hear from fourth year medical students is that patients don’t do what they ask them to, and that they feel that they simply can’t be responsible for any result of the patient’s lack of cooperation. There’s a jaded disregard almost as if the student who has come to this “acceptance” has experienced some rite of passage that has made them wiser. The most common reason for wanting to go to medical school is the desire to serve other people, born out of humility, compassion and a sense of purpose. Why is this driven out of us? What is it about us, and about medical school, or any experiences we have during these few years that cause us to change so much? Let’s examine this and critically look at the first and second years of medical school and maybe even more importantly, who we are.
Let’s examine our experience this first year. The first week we were instructed to focus on classes to the extent of not talking to our friend on the phone having a crisis. The hypothetical example was that our friend was breaking up with her boyfriend. Yet, this is exactly a time that our patients might be more likely to engage in risky behavior, which would diminish their health. A good physician might validate the emotional pain of such an experience and by inquiring about support from other people, encourage healthy activities to pass the time that the emotional pain is most acute, and reinforce the expectation that she will get better. The physician who lends more compassion to their patients than their friends is affected. Shouldn’t we be encouraged to embrace compassion in our lives, not just to adopt it and be able to turn it on and off like a spigot?
Who are we? We, us, medical students. We are a body of people who were chosen by an admissions committee to go to medical school. Who get’s chosen to go to med school? Those with excellent grade point averages, MCAT scores and “personal statements.” The capacity to maintaining loving relationships is not on the list. The capacity to prioritize giving up a contest to let your mom know how much you love her, it’s not on the list. Letting your dad know how much he’s done for you at a time that he’s lost his job and isn’t answering phone calls, it’s not on the list. However, sitting on a committee that organizes “tell people you love them” events might be on the list. Most of the time, humanity can’t be itemized.
The art of medicine is what makes us good physicians, and yet constitutionally, we are not the most humane people, to ourselves or to the people we love. Humanity is not something we have or have done and it’s not in a toolbox that we can take out and show off when people are watching. So where is the “art” of medicine? It’s in us, it is us, and sometimes, it’s missing.
Disclaimer: I feel that UIC is the least like this, and that the students are more cooperative than most.
Disclaimer Disclaimer: Even though we are as a whole least like this, students will do things like hide tags during a timed anatomy test so that the student behind them has to dig though cadaver for 40 seconds before they find out what the question is.
