“It’s just, like, acting like a human.” A fellow first year medical student eloquently summarized our Principles of Clinical Medicine class. The “techniques” we practice seem basic on first glance: Express the patient’s Chief Complaint in their own words. Ask the patient to describe the Onset of his or her symptom, what Provokes or Palliates it, it’s Quality, and so on and so forth to the tune of a convenient acronym. Explore socioeconomic or psychological drivers of a patient’s ailments by asking how her life is going, what affects her the most, and how she is coping. Always, always, even when the acronym does not explicitly ask, show Empathy. Also, wash your hands and clean your stethoscope between patients.
As an altruistic human being who has chosen the Noble Path of medicine, practicing these “common sense” communication skills should be easy for me. It’s just, like, acting like a human.
Two days before our first GIE exam, tensions were notably high. I found myself snapping at a lab partner, interrupting her question to ensure that we finished our dissection. I was terse with my boyfriend: when he expressed a long-standing and perfectly valid concern about our relationship, I burst into tears and sidetracked the conversation with my own issues. Strangely, the “basic human skills” taught in PCM slipped to the wayside when “medical school emotions” turned on high. I did not ask my partner when the Onset of his frustration was, or how I could Palliate it. When a student asked one too many questions during a review, I did not reflect on her psychological state. I did not repeat my lab partner’s Chief Complaint (or question) back to her in her own words, ensuring that it was answered comprehensively. I showed a marked lack of Empathy for fellow drivers on 26W.