On Monday morning, I was sick. I also had an immunology exam at 8am. Bristling from the cruel irony, I stopped at a Starbucks near the highway in yoga pants, a T-shirt, and my OHSU badge at about 7:30am. Red-faced from sneezing all night and baggy-eyed from attempting to study in that condition, I ordered a black coffee and waited miserably while my cup was filled. As I stood there, pathetic, a well-dressed, middle-aged woman approached me.
“What do you do at OHSU?” she asked, standing so close to me that I was acutely worried about spreading my germs. I told her that I was a medical student, and that I had an exam in just twenty minutes. She wished me luck. The barista handed me my coffee and I smiled politely and turned to leave, but the woman stopped me.
“So you’re going to be a doctor?” she asked. I nodded. “Can I tell you something?” She looked directly into my eyes. Again, I nodded. “I have spent a lot of time on the hill over the past few years with various friends and family who have been sick – and I want you to know that the most important thing is that patients trust their doctors.” I smiled in agreement and said that I often thought about my future patients when I studied. But she shook her head and touched my (no doubt feverish) arm. “I don’t mean trust their knowledge of, you know, bacteria and science…” (I had told her I had an immunology exam) “… I mean, that they trust their doctors as people. That they feel that their doctors are reasonable. I see doctors talking in the hallway, chatting with each other… patients pay attention to that. They want their doctors to have good judgment.”
Honestly, I didn’t really know what she meant – but she seemed so focused, so earnest, that I promised her I would share her comments with my peers. And so I am sharing them now, and hoping that through expression, I will begin to understand her more fully. Did she mean that patients want doctors to have a strong moral compass? That we would make wise, mindful decisions if we were in their shoes? Simply that we prescribe the most efficacious, least harmful treatment? That when we speak about or with our patients, in hallways, elevators, or patient rooms, that we show respect and humility? I trust my judgment when it comes to my own life, and the advice I give my friends and family – is this the same judgment I will soon use to counsel patients? Is this the judgment that she means?
As I said, I didn’t have time to ask her what she meant, or to ask her to share her stories of good and not so good doctors on the hill. I had to go take an immunology exam, to test my knowledge of interferons and antibodies and inflammation and infection. I don’t think that the judgment that she was talking about will ever be measured on a multiple choice test, but I hope that if I don’t have it already, I develop it over the (seemingly endless) years of training in front of me. What do you think she meant?