A couple of weeks ago I met my new medical students. These 10-12 trainees will be my small group for the next two years. We will meet monthly to discuss the soft stuff of medical training—hierarchy, tribalism, death and dying, medical errors, difficult patients, etc. Some call it “third year medical student support group.” This is my 6th year of the pleasure and privilege (I inherited my first group halfway through, when their previous preceptor moved out of state).
With each successive group I am ever more amazed at the students’ level of insight. They articulate compassion, humility, and maturity that I don’t think I had at their level of training. Or maybe it’s because we did not have classes like this to explore such things when I came up (or maybe I don’t remember?). More and I more I see my role as facilitator more than teacher. I am not here to impart medical knowledge. Rather, it is my job to stimulate exploration, conversation, and meaning. It’s so freeing, really—there is no standardized test to teach to. And yet I see it as my responsibility to help prepare these gifted young people to face the greatest challenge and reward of the profession: human relationships.
I feel no fear or trepidation. We cannot ‘fail’ at this class, any of us. Because the point of it is simply for everybody to participate, contribute, consider, and learn—myself included. Each month the students are given questions to answer in the form of a blog post. For example, “Recall an example of inspiring or regrettable behavior that you witnessed by a physician. Describe the situation, and its impact on you, the team, and/or the patient.” I read them all and facilitate discussion, tying together common themes and asking probing questions. My primary objective is to help them maintain the thoughtfulness and humanity that led them to medicine in the first place. Medical training has evolved in the past 20 years, for the better in some ways, not so much in others. One way we do much better nowadays is recognizing the hidden curriculum, and shining light on its effects, both positive and negative, through classes like this.
We all have those teachers who made a difference in our lives—or at least I hope we all do. I have multiple: Mrs. Cobb, 4th grade; Mr. Alt, 7th grade math; Ms. Townsend (now Ms. Anna), 7th grade English; Ms. Sanborn, 7th grade social studies; Mrs. Stahlhut, 9th grade geometry; Mrs. Summers, 10th grade English; Coach Knafelc, varsity volleyball; Dr. Woodruff, primary care preceptor; Dr. Roach, intern clinic preceptor; Dr. Tynus, chief resident program director. My mom is one of these teachers, also. She leads nursing students in their clinical rotations. I have seen her student feedback forms—they love her. And it wasn’t until I heard her talk about her students that I realized why they love her and what makes her so effective—she loves them first. Teaching is often compared to parenting. Our parents, at their best, see our potential and love us into our best selves. They cheer us, support us, redirect us, and admonish us. They show us the potential rewards of our highest aspirations. If we’re lucky, they role model their best selves for us to emulate.
All of my best teachers did (do) this for me. I’m friends with many of them to this day, and I still learn from them in almost every encounter. I love them because I feel loved by them. They held space for my ignorance and imperfections. I always knew that they knew that my best self was more than the last paper I wrote, the last test I aced, or the last patient encounter I botched. To them, my peers and I were not simply students. We were fellow humans on a journey of mutual discovery, and they were simply a little farther along on the path.
This is my aspiration as a teacher, to live up to the example of all those who loved me into the best version of myself today. This kind of love allows for growth and evolution, from student to colleague, to friend, and fellow educator. This is not something attending physicians typically express to medical students, positive evolution of medical education notwithstanding. But when I met this new group, I was overcome by love for them. So I told them. “If you take away nothing else from our two years together, I want you to have felt loved by me. I wish to love you into the best doctors you can be. That is my only job here.” Or something like that. It was impulsive and possibly high risk. But it was the most honest thing I could say in that moment, my most authentic expression of my highest goal for my time with them. I only get to see them once a month, and I want them to be crystal clear about what I am here to do. We have lots to cover these two years, so much to learn and apply. And love is the best thing I can offer to hold us all up through it.
NaBloPoMo 2016, Letters to Patients, Day 3
To My Patients With Diverse Occupations:
What a pleasure and an education to know you!
I think none of you are plumbers, though. But I remember the first time I met a plumber—it was in college, a friend of a friend. To this day I wonder if he thought I was a little crazy—I grilled him mercilessly about his work. Was it like “Moonstruck,” is copper really always better? What’s the grossest thing you’ve ever seen? What do you need to know, is there plumbing school? How do you know when you can’t do a job? What equipment do you carry around?
I have only ever known medicine, you see. I resisted at first—so typical, the Chinese kid who wants to be a doctor. But then I volunteered to be a health aide in college—I got to move into the dorm a week early that way. And it was inevitable, I was hooked! So I went ‘straight through,’ as they say—biology/pre-med, no gap years, no real life working experience before medical school.
Traders, dog trainers, book editors, retail managers, accountants, nurses, call center agents, firefighters, small business owners, truck drivers, professors, musicians, actuaries—you all have such interesting lives! One of my favorite parts of the history is when I get to hear what you do for a living, because it’s so different from my own. So please be patient when I interrogate you about your work, I’m just so curious! How do you spend your days? What makes a great day for you? What makes it hard? What are the greatest sources of stress and meaning in your work/career/vocation? What do you love about it? Would you choose it again?
This curiosity stems from my deep desire to relate. In your work, people probably present you with problems. You apply specific expertise to diagnose the underlying condition. You determine the most appropriate or attainable solution, and map out a path to achieve it. You take some responsibility for the result, while recognizing that your coworkers must also participate fully for the team to succeed. On your best days, the collaborative effort yields not only the desired outcome, but also a deepened connection between people. It’s not so different for me.
It’s easy to perceive a distance between you and me, between patients and physicians. Medicine can seem elitist sometimes, what with the onerous entrance exams, the stiff competition for school admission, and the prolonged and grueling training. But in the end I bet we share more experiences than we realize. I’m just here to use my little heap of knowledge and skills to help others, and I know that’s what you do, too.