Skip to main content

A New Standard

10580105_10152275116807321_8518590284876316669_n

The MS2 + MS3 panel with the new Muncie MS1 group during Indy orientation (right before they got their white coats!!)

Hello again! We’re back in the swing of things here in Muncie. Being an MS2 is pretty different than being an MS1. First of all, we’re no longer on block schedule…so everything feels a lot more slow-paced (aka we don’t have a test every single week). It made the transition back to school easier since it was pretty laid back. The difficult part of not being on block is forcing yourself to study even without weekly tests to “motivate” you. It’s easy to get super laid back super fast (i.e. I barely studied the first 2 weeks…and then suddenly a test was coming and I had to kick it into high gear). Second of all, many of our teachers are physicians this year. We just finished up the OB unit (which I loved) and all the physicians who taught it were awesome. It’s funny to already notice some obvious personality differences among specialties (OB/GYN vs. Emergency Med vs. Endocrinologist…etc.) and it’s fun to consider which group I see myself fitting into!

Ok, enough for now about school. Let’s rewind to the summer. They call it the “last summer of your life”…which sorta puts a lot of pressure on you to make it amazing! Haha. I attended a Whole Person Care Health Preceptorship in Southern California. It truly was amazing: I learned so much about patient care, had a ton of fun, made great friends, and have already been putting a lot of the knowledge into practice. Feel free to email me (risellad@iupui.edu) if you have questions about whole person care or the preceptorship!

One of the core points of whole person care is realizing there are so many factors affecting the person walking into your office. For example, they may have made an appointment to see you because they have a headache. Medical professional or not, most of us are aware that Tylenol can be great for headaches! So say you take a history, there are no major red flags, you prescribe some Tylenol and send them on their way. That could work out for you and the patient.

But what if you somehow had the ability to see into the patient’s mind and found out more about him: he hates his job, but can’t quit because he needs to support his family; his wife is pregnant and they’re worried about losing the baby because her friend recently had a miscarriage. Also, he’s really scared about these headaches, but feels embarrassed to show his fear; however, one of his co-workers was diagnosed last year with a brain tumor and he’s secretly convinced that it’s only a matter of time before the same thing happens to him.

If you saw all that, would you still hand him a couple pills and send him on his way? Even if you were 100% sure that the Tylenol will take care of the headaches and there’s nothing else to be concerned about? I hope not! Most of us would probably talk through some of that with him, possibly refer him to outside resources for further help, and realize there’s a lot happening in this man’s life–no wonder he’s getting these headaches!

10385297_10152315681007321_6851904112075711203_n

Pretty details at The Caffeinery in downtown Muncie

Lesson 101 in med school: Take a good history. I’ve heard that repeated by so many physicians. We don’t get to see into a patient’s mind, but we have the immense blessing of being in a role where people trust us. Patients will tell you things they wouldn’t tell a close friend. I’ve been in the room when that happens. Even as med students, we wear a white coat–and that white coat sets us apart. People will open up, if you give them time and a safe place to do so. And once you have that information–once you’ve seen into their mind–you can offer much better care, because you’re more aware of their needs. The physical symptoms of the headache could be fixed with Tylenol, but the emotional and mental stress will just lead to more headaches–that stress needs to be addressed.

I believe this “whole person care” also applies outside of the hospital/clinic. In medical school, things can quickly become robotic. Know these specific slides to ace the test. Follow this specific rubric when you make your presentation. Memorize this specific checklist to take a patient history. Standardized everything. In some ways that’s good–it means we’re all being judged by the same criteria and taught the same information. In other ways, that’s very bad though. There’s a fine line between standardizing information and standardizing people. As we’re all fed the same information, handed the same rubrics, and trained to achieve the same proficiencies, we can become robotic. We become slaves of the check list.

And when that happens, we forget about people. That patient has a name, a story –there’s more to him than the information we’re required to obtain. One of my personal goals is to avoid ever referring to a patient by his/her disease. The patient may have a disease, but he is not defined by the disease. His worth is not determined by his disease.

All the structure and standardizing will likely produce efficient physicians–which means the schools have done their jobs. But the school isn’t solely responsible for making us good doctors. We play an active role in that…a role that extends beyond studying for exams. When we’re not actively seeking to fulfill that role, we forget why we wanted to be doctors. We get so engrossed in studying and meeting expectations that we forget that there’s more to life than school/work. We forget to care for the people around us–in our class, at the gym, at the grocery store, etc. We forget about family and friends who cheer us on from afar. We forget about ourselves. We hide the way we feel because it may seem like no one cares…so we’ll just say it’s a metaphorical “headache.” We won’t tell people about all the other stuff going on in our lives. We’ll be satisfied with the quick fix, instead of sharing what’s really going on…instead of confronting all the issues and saying the 3 words we expect from our patients but somehow believe we should never utter:

I need help. 

And that “I’m fine, you’re fine, we’re all fine” mindset in med school needs to stop. Check out the statistic from this recent NY Times article (in response to 2 medical residents committing suicide) if you need more proof:

In a recent study, 9.4 percent of fourth-year medical students and interns — as first-year residents are called — reported having suicidal thoughts in the previous two weeks.”

As future physicians–as human beings–we need to care about our health and the health of those around us. And I don’t just mean physical health. I mean mental, emotional, spiritual health. Take the time to find out why you’re really so stressed. Is it really the “headache” of the upcoming exam? Or is it something more?

10659173_10152339928482321_6959023464183467101_n

Sometimes even Muncie will cause you to stop and admire the beauty :)

Whoever you are, medical student or not, remember this: YOUR WORTH IS NOT DETERMINED BY WHAT YOU DO. You are so much more than a medical student. You are so much more than that grade. Your worth is NOT determined by what you do.

Take the time to notice the people around you. You can’t read their minds, but you can always ask questions. Take a genuine interest in people even when–especially when–it won’t benefit you in any way. The studying is necessary to succeed as a med student. But the interest in other people is necessary to succeed as a human being.

You have no idea who may need a smile, a laugh, a kind word today. And you could offer that to them. You can help people feel better even without those two letters after your name. You can offer a listening ear–that goes such a long way. It’s really amazing how even complete strangers will open up to you when they realize you care. People are often shocked to see someone care about them–especially someone they don’t even know. You’ll be surprised at the life stories and heartache and burdens that will come rolling out of a complete stranger’s mouth when you just take a few minutes to show you care.

So make that a goal for this week: keep your eyes open and ask the simple question, “Is everything ok?” And actually care about the answer. You may need to ask this of yourself. You may need to ask this of a friend. You may need to ask this of a stranger. Ask and listen and help in any way you can, then seek out other resources if necessary. But don’t be afraid to ask. And friends, don’t be afraid to answer honestly. There is no shame in admitting you need help. Life is too precious to waste. Everyone has struggles–don’t let the struggles control you. Get the help you need and be the help someone else may need.

Let’s make this a new standard: genuinely caring for the people around us…even when we’re busy/stressed/tired. Easier said than done, yes. But that doesn’t deflect from the fact that it needs to be done. Play an active role in becoming an excellent physician one day by being an excellent person today.

So take a deep breath, look up from your work, and smile at someone today. Life is short. Life is precious. Make yours count.

******************************************

FYI:

Sometimes as med students, we need a break from notes and text books. I’m an editor over at In-Training, which is a great resource if you want to hear/learn from other medical students! Or if you want to write about a personal experience that has affected your medical training! There’s strength in knowing that other people are going through similar experiences. Also, stay tuned for an exciting opportunity that I’m working on with In-Training to foster more of this “genuine caring” mentality. Lastly, but most certainly not least, if you’re interested in a great article about this “let’s not be robots” topic, please read this article written by Navdeep Kang. On August 27, 2014, Navdeep Kang died in a motorcycle accident in Maryland. He was a fourth-year medical student at the George Washington University School of Medicine. There is much truth in the article and his words will certainly live on.

The views expressed in this content represent the perspective and opinions of the author and may or may not represent the position of Indiana University School of Medicine.
Author

Roshini Selladurai

I’m an MS4 based at the Indy campus, though I spent MS1/2 at the Muncie campus. I started med school with a strong interest in international missions, pediatrics, education, and whole person care. I’m still interested in all those things, except I re...