Medical Student Reflection I: Reflections from the Hallway

Fourth year Johns Hopkins medical student, Helen Prevas, just completed a 2 week elective offered by the Miller-Coulson Academy of Clinical Excellence. During her time, she shadowed many of the member physicians in their clinical settings. Through a series of blog posts, Helen documents some of what she learned and witnessed during her elective.

As medical students, we witness incredibly personal moments in the name of developing into excellent doctors—from births to hospice visits to code status discussions. So it was surprising to me that after four years, Ms. C was the very first patient to request me to leave the exam room. Her doctor’s “one-liner” outlined Ms. C’s full recovery from a serious illness and her residual anxiety, not always medical-related, that responded to much more frequent visits to the office than any protocol prescribes. Although she welcomed me into the room with her doctor and gave only some hints at underlying worries, it was not until the physical exam portion that Ms. C drew the line. She was apologetic but firm: this conversation was for her and her doctor, alone.

I respect patients’ wish for privacy, and even more, respect the doctors who earn and keep that special trust. There is something in the sitting and listening quietly while someone shares their deepest fears. But how can we hope to reach that point? Her doctor gave me her perspective on establishing the doctor-patient relationship. She said, “I learn about the social stuff, I learn them inside and out as a person. The medical part comes afterwards.” I have heard this sentiment repeatedly from members of the Academy for Clinical Excellence who are adored and trusted by their patients. Sometimes, it is more important to write the names of all the grandchildren in the chart, to know golf handicaps, to remember favorite sports stars than to recall blood pressures, lab numbers, or medication lists. While I did not personally get to know Ms. C, she has taught me more by what I did not directly observe and had to infer from my place in the hall, outside the room containing her and her doctor. From the initial visit to the ones fifteen years later, the foundation for a doctor-patient relationship is ultimately a human connection based on listening, sharing, humor, the desire to know our patients as people, and above all, earned trust.

--Helen Prevas, MS IV