Sunday, 22 September 2013

On Patients and Privilege

I've been a bad blogger, I know. It's been almost two weeks since I've posted - school has been so busy, and by the end of the night when I'm done my prep for the next day all I want to do is put my computer away. I'll try to be better and post more often though.

So, on Friday my tutorial group got to see our first patients. Whoa. Now, I should clarify here: when I say that we got to see our first patients, I don't mean that we treated anyone - far from it! In clinical skills, we're currently working on history taking, so when our preceptor walked into the room to start our session, the first thing he said was "so, are you ready to head to the wards?". We knew that we might be interacting with patients this week, so we had all prepared checklists for history taking, but we figured that we might sit and go over them for a while before jumping right in. Luckily, our preceptor took us to the room of an incredibly friendly patient who was willing to sit there for half an hour and let us ask all kinds of questions in order to put together a history. This particular patient was hoping to be discharged this weekend, so we all appreciated the fact that they were so willing to answer questions that they had probably answered 10 times just to help us learn, without any real benefit for themselves. (I apologize if I'm being super vague here, I just want to make sure not to give away any details). So, in a nutshell, best first patient ever. The other students in my group and I all have a few pages of hastily scribbled notes, and have instructions to type them up into actual histories that we can bring to class and present next week. Then, we might even get to go talk to more patients!

After we had taken our patient's history, our preceptor decided to take us down to the unit where our other preceptor was working to see if she had any patients we could talk to (for clinical skills, our group is lucky enough to be taught by a team of two amazing doctors who have been teaching students together for 10 years). Instead, we got there and found out that she was in the middle of a procedure, and actually asked for an assist from preceptor #1! Luckily for us, that meant that we got to go into the room and observe, as long as we followed two simple rules: 1) stay out of the way, and 2) don't talk. Haha. Easy enough. So, we got to watch them work for half an hour trying to place a femoral line. So cool.

After the procedure was over, our preceptors decided that in order for us to know what questions to ask a patient, we need to also have a solid clinical background, so they took us into a conference room and pulled up a bunch of lab tests to go over with us (echocardiograms, x-rays, CTs, etc). It was a great learning opportunity, and I was proud of myself that when they asked spontaneous questions I actually got a couple of them right. Woohoo!

The story of my afternoon does have a point, though, other than just a narrative of my day. It was a really interesting experience, getting to walk into restricted areas of the hospital without anyone questioning me (an ID badge is a powerful thing). I'm not going to lie, I did a little happy dance as I walked past the volunteer check in desk without actually having to check in, haha. I was talking to some of my fellow students about it, though, and we were all pretty conscious of the transition we're going through, from pre-med wannabes to actual, legitimate, medical students. It's a really privileged position that we're in. People trust us, just because we're a part of the medical profession. We took a history from a patient, and the patient answered every question we asked without hesitation, because we're med students. We get to go into patient rooms and observe procedures, because we're med students and we have to learn. People trust us and are willing to open up to us, because (as they keep telling us at school) we're the newest members of a trusted profession. It's an amazing feeling, but it's also a lot of responsibility.

A story that, to me, exemplifies what most of us are feeling right now was told by one of my favourite authors, Louise Penny, when my mom and I saw her speak in January. Louise's husband is a retired doctor, and he's the former Director of Hematology at the Montreal Children's Hospital (aka he took care of children with cancer for the majority of his career). I actually had the opportunity to meet him this past week, when I saw Louise speak once again, this time with an amazing friend who got Louise to sign a book for me. Anyway, Michael is an incredibly sweet man, and Louise always talks about how wonderful he is and what an appreciation he has for life after seeing every day at work how valuable life really is. Back in January, Louise was telling the audience a story of a Christmas party that she and Michael were attending at the Children's Hospital not long after they had met (at this point, I believe Michael was still the Director of Hematology). All of the children who were inpatients at the time and their families were enjoying the festivities, when Louise noticed Michael standing with his back to the room, looking at the wall. She went over to find out what he was doing, and she noticed that he was crying. When Louise asked him what was wrong, he replied that he knew which of the children in the room wouldn't still be alive for next year's Christmas party.

Whoa. I know I didn't write that nearly as well as Louise told it (which is why she's the New York Times bestselling author and I'm not), but let me tell you, there was not a single dry eye in the room when she was done (and I'm misting up a bit now as I rewrite this). My point is, doctors are trusted with a tremendous amount of privilege and responsibility. People invite us into their lives, sometimes the very worst moments of their lives, and they trust us to take care of them. Patients answer our questions, and let medical students watch as they have a procedure done. It's a crazy thing.

I know that this week was just the tip of the iceberg, and as time goes on I'll become more and more involved with patients. What I hope, though, is that I never forget this feeling of privilege at the beginning of medical school. I understand that to do your job well as a doctor you have to find a way to stay professionally detached, but I think it will be important to remember how lucky we all are to be part of the medical world.

Now, I think this might have been a bit of an unintentional downer, so I'll end with one last plug for Louise Penny and her books - you can read more about her here. I'm also happy to lend my copies out if anyone wants to get into the series.

I promise to try to write more often, though my posts may not always be this long. Thanks for stopping by my little corner of the internet. :)

1 comment:

  1. Thanks for the update, Lisa (I'm sure you're incredibly busy). Your (well, Louise Penny's) story brought a tear to my eye, too, but that's not a bad thing. Keep remembering your humanity and you'll do great.