At seventeen, I envisioned two types of physicians: the doctor who cared about me and my needs, and the doctor who was cold and detached. At that point in my life, I had experienced both types of physicians from the patient perspective. My dream was to become a physician. I wanted to be the empathetic doctor, the one who saw the patient as a person. I aspired to become the provider who grasped the patient’s story before the data, research, and algorithms. How could I make this happen?
My university search had started, and I was quick to avoid universities solely with biology degrees. I wanted something different. A providential Google search led me to a medical humanities program in Texas. “What is medical humanities?” This university was a three-hour flight from my home in Connecticut. My parents were not very enthusiastic about this leap of faith, but they supported me on this quest. I had gone to school on one street my entire life. Was this program worth it? When I toured the university, I was given the opportunity to sit in on a medical humanities course titled “End-of-life care and bereavement.” The conversations were raw, genuine, and collaborative. I trusted this program would be instrumental for me to become a “good” doctor.
I spent the next four years taking medical humanities courses alongside my science curriculum. My courses included topics like philosophy and medicine, disability and society, and bioethics. I authored my thesis on empathy in health care and was accepted into medical school. In medical school, the long hours of studying pathways and pathology promoted a mechanistic thought process. I knew this, but there was nothing to be done to reject it. Like quicksand, the more I fought it, the worse I sank. It was challenging to remember the viewpoints and goals I had developed, as my medical humanities knowledge base never had the opportunity to rise to the surface. In the earlier years of medical school, my patient contact was limited. When I did have clinical experiences, it was with a standardized patient and an instructor who was grading me. When I was tested, I had developed a monotone “I am sorry for your loss” response in order to check the empathy box.
When starting residency, I had hoped the transformation from medical student to physician would provide change. However, survival mode had kicked in again, and lab values, imaging, and disease pathology took precedence in my mind. I caught myself not knowing patient names but only room numbers and diagnoses. I listened to patients, but heard lung sounds and differentials before patient experiences. I was disappointed in myself when recognizing my approach. I had spoken at conferences on the importance of empathy in health care, and here I was failing to remember what I preached.
With reflection, I realized that fear and burnout are the greatest factors in losing touch with empathy, which is a cornerstone of medical humanities coursework. Once I had this moment of insight, I strove in my daily encounters to see the person before the patient. It included simple approaches, like writing a patient’s full name at the start of a note instead of “patient.” By this slight change, my intention was redirected.
I am grateful for my medical humanities experience at my university. My professors and their courses laid a foundation at the start of my health care journey that could withstand the storms of medical training.
“If you are going to be a doctor, be a good doctor” is the phrase my grandmother likes to repeat to me. It is a phrase that needs to be repeated often, as we all need this reminder.
Nicholas Bellacicco is a neurology resident.
