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Attentive questioning: You can’t learn this in a medical school classroom

Christine Sunu
Medical Education
September 15, 2014
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I don’t remember how many patients I saw at the health fair before George came to me; none of them were as memorable. George was a tall, stooped man with a serious expression. His skin was weathered but he couldn’t be called elderly by any means. I guessed that his age hovered somewhere around forty. He looked serious and spoke quietly. He had no interest in being rude, but no real interest in responding to my questions, either. He hadn’t come to the health and homelessness fair for chitchat.

The questions were simple. When was your last medical appointment? Have you ever had high cholesterol? High blood pressure? Do you drink?

George hesitated when I asked this. Do you drink? He looked at me and looked at the air between us. “I used to,” he said, his voice determined and unwavering. “Not anymore.”

This was a point I could easily have ignored. Many novice medical students, myself included, experience discomfort when presented with potentially emotional answers. Should we ask for more? Is it medically relevant? It always seems easier to ignore the emotions and proceed with the medical interview.

Speaking with George that day, I asked him to tell me more. And the fabric that swaddled his private life split open before me.

George and I spoke for a long time. He told me about his life and the trials he had undergone since the deaths of his wife and daughter. He told me about how difficult things were and I found that the words, “I can’t even imagine,” were simultaneously true and untrue. Because even as I said them I found myself imagining, caught in George’s life, feeling a quiet echo of the things he once felt. We remained at this dance for a while — him voicing an emotion, and that emotion resounding in me.

There was little medical relevance to the information George gave me. But I cannot stress enough the importance of the connection we made. Lectures and simulated patient encounters could not teach me what George showed me about empathy. My connection with him was not only a motivating factor, pushing me to seek out other providers and ensure that he received the best care; it also allowed him to share information with me that he otherwise may have thought unimportant, and it established a relationship where he was more likely to take my advice.

All this because I asked him for more information during that nerve-wracking moment of emotional ambiguity. Because of George, I believe more than ever in this kind of attentive questioning. It created between us that open, empathetic relationship that seems crucial and central to the practice of medicine.

Christine Sunu is a medical student. This article originally appeared in The American Resident Project.

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Attentive questioning: You can’t learn this in a medical school classroom
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