Thursday, June 02, 2005

Transformed by medical training?

This post by the Medical Madman prompted some of my own thoughts on one part. He quoted this article:
Studies suggest that medical students become less compassionate by the end of medical school, that during the process of professional socialization, their original "commitment to the well being of others either withers or turns into something barely recognizable." In between, they have shifted their focus from the patient to their own learning process.
and commented:
Is this universally true? Of course not. She’s right in that it happens to most medical students and residents. It’s a consequence of feeling overwhelmed with the body of knowledge one must master. It definitely happened to me as an intern. I’d like to think that as a second year it's resolving and that I now see patients as human beings, friends even.

I remember as an intern on surgery sitting up all night with a 60-something man from Coronado who was to undergo a colectomy the next morning for cancer. As we talked about his family, his disease, his future and prayed together, we bonded as I have with few other people. I kept up with him until his death a few years later, rejoicing with him his surprising and miraculous survival. He died from a completely unrelated cause.

OTOH, I was talking to a hospitalist about a drug screen that was positive for "amphetamines." To his comment that several OTC meds can cause this screen to be positive, I responded, with cynicism, "If you work in the ER in this part of TN, with this age group, this means nothing but methamphetamines."

I confess that, very recently, I started an ER shift by being impatient and fairly rude to my first patient. As I saw the hurt in her eyes she said, "Give me time, I'm 84 years old." I made time to listen to her about her life and her concerns. As I was saying goodbye, I was able to tell her, truthfully, that I really enjoyed visiting with her. She responded by telling me that the time I spent with her was the most any doctor had in many years, and how valuable that was to her.

That really set the tone for an enjoyable shift.

Thanks, Madman, for prompting these thoughts.