At the outset of this process of becoming a doctor, a friend and mentor of mine, a professor emeritus of medicine known as a mentor who cares deeply about his students and for his New England style dinner parties, sat me down to explain the gist of medical school.
The first two years, he explained — bowtie notwithstanding — are the equivalent of studying a language from textbooks. You must first learn grammar and syntax rules. The final two years are your opportunity for language immersion. You become fluent in the language of medicine, and then comes residency, where you learn to truly care for patients. It is imperative, he said, to understand that medicine is in fact a language and a culture, and one you studied hard to learn, and one that your patients have not dedicated years of their lives to learning. Part of your job will be to translate.
Coming into this process, I would have said I only spoke English. Now I would reflect on that time almost three years ago and say I probably spoke two fluent languages: English and Patient.
In my life as patient, I say things like “low blood sugar” or “feeling low.” I refer to drugs by their brand names. I have a fast heart rate when my blood sugar drops. As a budding physician, I now call this hypoglycemic with tachycardia. I have learned the generic names of the medicines I have been taking for more than fifteen years.
At this point in my medical training, I admit that shop talk is alluring. It carries with it the novelty of new language, accompanied by the bonus of impressing residents and attendings as a means of demonstrating what a precocious learner I am (or rather, a desperate attempt to do so). Meanwhile, my new jargon does very little to impress my patients.
I find myself dreaming in Doctor these days rather than in Patient. As a medical student, I’ve already begun to take pains to keep my Patient fluent. I’ve listed my most relevant insights below.
1. In my regular daily life, I don’t go out of my way to disclose myself as a medical student. This avoids the temptation to talk shop with other health professionals from the get-go. When I’m at the vet I actively listen to how she explains metronidazole or Zofran to me (and wonder why on Earth my dog needs Zofran as a comfort measure for his bout of stomach illness) and take note of what strategies I can adopt to explain medications to my own (human) patients.
2. I talk to non-medical people in my life. For students with significant others and roommates outside the medical field, this is easier to do, but it certainly doesn’t go without saying. For a large cohort of medical students, medical school can be so immersive that human interaction is centered on peers, mentors, attendings, residents and our own doctors (as we attempted to self-diagnose everything in the first year curriculum). Stay fresh by staying social. It’s almost sad that I have to include this on my list of tips, but it’s certainly relevant.
3. I read both medical journals and non-medical books. Not only do I have to be able to speak to patients, but I also have to be able to communicate in writing. I am a firm believer that good reading begets good writing. Again, I keep my skills sharp via exposure.
4. I allow my patients to describe their illness first before I describe it to them. I use the jargon they use. This has the added benefit of reflecting back to them that they are being heard.
The utility of knowing our strengths is that we can hone and protect them. My hope is that by creating strong habits now, I can keep on the forefront of my mind the simple question: how am I communicating with my patient?
Heather Alva is a medical student. This article
