By my second week of medical school, I was fairly certain that I had chosen the wrong profession. While my classmates raved about how much they enjoyed learning about signaling pathways in our biochemistry class, I futilely attempted to memorize the differences between the mTOR and the Jak/STAT pathways. The numerous biochemical abbreviations were a foreign language to me. Gray’s Anatomy, atlases of the human body, and histology textbooks glowered disapprovingly on my bookshelf, as though to indicate that perhaps I would understand my classes better if I had actually removed the shrinkwrap from my books and read some of them.
It was impossible. There was no time to eat, attend an average of twenty-six hours of class a week, sleep, and function as a normal human being if I did all the work I was assigned. Piles of laundry accumulated, and I hid them in the closet. My cooking and baking skills were forgotten, and I boiled pasta for dinner every night. As my life became more mechanical and routine, I began to forget what had drawn me to medicine in the first place: its enormous potential to ease the suffering of those who had nowhere else to go. Daily concerns had overcome my life, and I couldn't think about my future patients who I would heal four years from now when I didn’t have the energy to get through the next week.
A week later, I started a class at one of the hospitals that centered on building relationships with patients. I was assigned a patient to interview and had to obtain a history of the patient’s present illness and past medical problems. As I walked into the hospital in my stiff, barely-worn white coat, I panicked. I hadn’t even mastered the steps of the glycolytic pathway yet, so how was I supposed to talk to a patient about her illness? I had the vaguest idea of human physiology—the only thing I gave myself credit for was knowing that the heart was on the left side of the body and that there was one lung on each side of the chest—and felt physically ill every time I saw blood being drawn from someone. What could I ever do to help a patient?
With some trepidation, I entered my patient’s room and introduced myself as a first-year medical student. I sat on a chair near her, and could think of no other way to begin the interview other than by blurting out, “And how are you today?” I immediately felt like an idiot. How else could she be other than sick when she was hooked up to an IV and had lain in a hospital bed for five days? Flustered, I told her that this was my first interview, and the woman just smiled and said, “That’s ok.”
As we began talking, I devoted my full attention to her. When we talked about her illness, instead of pretending to be the expert, I confessed that I knew nothing at all about it and asked her to describe it to me. I was excited and interested in a way that I had not been since the beginning of medical school. When she talked about how being ill had impacted her life, I discovered that she wasn’t just a sick patient in a hospital—she was a person. I empathized with her and offered her my sympathy.
More importantly, I understood her in a way in which I couldn’t understand something taught in a classroom. I saw the full complexity of a person who, to other people, would just be a representation of a disease. But my patient’s disease wasn’t her life. This illness was a part of her, but if I focused only on its cure and applied only the knowledge learned in my science classes, I would never reach the deeper levels required to actually help her. I would never feel inspired to build a trusting, meaningful relationship with her, and I would be failing in a core part of my commitment to society as a physician: to be the person who people could turn to in times of distress. Of course, understanding the science behind disease was important, but without compassion and empathy for one’s patients, knowledge alone was a cold hope to offer someone. That day, I began learning the steps necessary to become the type of physician I had imagined myself to be, and I learned them from a patient.
Now, when I groan about the number of enzymes I have to memorize, I think about my very first patient, and I have a sudden burst of inspiration, and memorization becomes just a little less tedious. If I keep this up, I may even get around to opening up my anatomy books sometime soon.
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