It’s hard to believe that nearly 1.5 years ago have elapsed since my first-year orientation to medical school. Much of it seemed protocol with session after session on rules and regulations, but I vividly remember the few hours spent outlining standardized patient encounters and how my assessments over the next four years would be based on my interactions with a complete stranger. As alien as that idea sounded to me, I felt more surprised upon hearing one patient’s advice, “I can’t tell you how many times I have individuals come in here and use words like ‘exacerbate.’ Speak to a patient as though you were speaking to your grandparents.”
I wondered how anybody could speak in such a cold manner, especially since I had come to learn the intricacies of communication over the last seven years as a youth group coordinator for the local chapter of BAPS, an NGO in consultative status with the UN committed to empowering youth through spirituality and service. Each Sunday, our group of high school and college students convene to discuss topics centric to character and Hindu culture, like vegetarianism and introspection.
Obviously such topics don’t naturally stimulate this age group, so I realized the need to parallel these topics with their interests. Introspection intrigued them when we looked at a documentary explaining Batman’s ability to match his foe’s ferocity but only if it did not violate justice, like leaving a villain for law enforcement over dishing justice himself.
Empathic communication requires we imbue a message in an audience’s language, in line with the patient’s advice, but two years of medical school have demonstrated how all that can unravel.
Learning physiology, immunology, biochemistry, and other topics compared to the force of a fire hydrant opened as the torrent of knowledge forced down our throats. I remember struggling to use words like posterior and superior in presenting our dissections during anatomy lab, so my professor encouraged me in that it would get easier with immersing myself in the material.
With time away from the lab spent in study, it did not take long for me to master these words, even conquer them. Flaunting these words as the spoils of another exam justified the toll it took on our emotional energy, and we found ourselves the most vulnerable to the short-term satisfaction of ego. Empathy requires energy, and with none to spare, we rescind into using words like exacerbate as early as our standardized patient encounters.
By no means should we abandon medical jargon, but we need to bridge patients from their world into medicine. I remember shadowing a family medicine physician with a female patient in her mid-40’s come in for a follow-up visit after being diagnosed with pancreatic cancer. Non-alcoholic, non-smoker, no family history — I could sense her helplessness given that she did not fit the risk. The doctor took his time explaining the pancreas as a “bag of chemicals that help process food” and answering her other questions. Never once did the woman feel unable to understand, even when she was one of the last patients for the day.
Exhausted, the doctor could have easily construed a sound byte filled with scientific terms, but he would’ve traded empathy for ego. Moments like these helped me realize that while empathy may require effort, it renews us with the purpose needed to passionately serve our patients. Communication is but one outlet.
Rushil Patel is a medical student.
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