Notes from a Medical Student:

Communication Is Key

One of the most important things that they try to teach you in medical school, besides how to recognize and treat different diseases, is how to connect with your patient. The importance of this topic to quality health care is starting to be stressed more and more in medical schools across the country. I was recently told by one of my lecturers that most medical students are great communicators-until they get to medical school.

My first course was anatomy, and it was an absolute nightmare, not because it was difficult to learn how to study to the degree necessary (although it was), but because I was confronted with what seemed to be a whole new language. While cleaning out my apartment recently, I came across one of my first lab exams from anatomy. It reminded me that during those first few months, I could barely pronounce, let alone spell, the vast majority of my answers on that exam. Over the past two and a half years, however, something happened. This new language became my first language. No one ever tells you this is going to happen. It just sneaks up on you, and one day you look across the table at your mother or sister after venting about the details of metabolic disorders, and she is giving you a blank stare.

Now, two rotations into my clinical years, the doctor-patient relationship and the ability to communicate effectively with patients have become the struggle of my everyday life. How do I get my patients to understand what I am telling them and what it means for their current and future health? Working with so many physicians, I have seen a wide range of communication skills. I have been extremely impressed by some doctors' abilities in this realm, and at other moments, I have walked out of exam rooms with the distinct feeling that the patient didn't have any idea what the doctor had just said.

What I have learned is that in order to be a good doctor, one must, above all else, be a good teacher. I have met some brilliant people in my lifetime, but it takes more than just being smart to be a good teacher. Some of the best teachers I have ever had were the people who were able to take tough information and boil it down into small, easily digestible ideas.

The key to good medicine, then, is figuring out what it is that your patient understands, and what needs further explanation. This is rarely an easy task, and it requires medical students in their clinical years basically to develop a multiple-personality disorder. Among the hierarchy of physicians who evaluate our performance each day, we must be technical, precise, and formal, but in the exam room, we must transform ourselves into whatever we need to be for that particular patient.

My current rotation in pediatrics has given me a great venue in which to practice this skill. Three-year-olds probably cannot point to where their liver is, nor do they have any idea what the word "regurgitation" means. Words like "tummy" and "ouch," long gone from my vocabulary, have resurfaced. Along the same lines, not every adult understands what it means to say someone is "septic" or that they are "not tracking properly." I have to remember that up until two years ago, before tens of thousands of hours of studying, I wasn't really sure either.

I am lucky in that my school encourages its students to work on communication. Each patient is a new opportunity to learn and to teach, and I have no doubt that I am becoming a better physician as a result. What good are the skills and knowledge I have worked so hard to amass if I can't use them effectively? So, each day I work to find the right words, gestures and expressions, and with each patient I try to learn to be a good teacher and a better doctor.