I brace myself and walk into my Mr. M’s room. It’s almost 10 a.m., but the lights are off and the blinds are drawn. The air tastes stale. Mr. M has turned his back to the door and is staring intently at the wall. As I ask to listen to his lungs for the fourth time that morning, Mr. M turns his frustration from the wall to me. “You can’t be serious. The resident just listened to my lungs five minutes ago! Why don’t you know what’s wrong with me? I don’t want you waking me up any more.” I apologize and leave the room, telling myself that he is just a difficult patient, that I did my best, that he doesn’t want to see me so I should leave him alone.
The next day, Mr. M’s wife visits and recounts for the team his story. Two years prior, he had been the picture of health. He was upbeat, enjoyed hiking, fishing, and having his family over for barbecues. He had a great sense of humor and had endless stories about good times with his grandkids. But slowly, he began to change. He first lost his energy, then started having difficulty breathing. For two years he had been going from doctor to doctor, trying countless treatments, but still he continued to get more ill. Now, he hardly has the energy to get out of bed, and as doctors tell him his other organs are not working properly, they still cannot tell him why. I realize that the sullen, frustrated man that I have been talking to is entirely different from the person Mr. M’s family sees, and is not how he sees himself.
My experience with Mr. M came halfway through the clinical trunk, the year in the curriculum when UMMS students are introduced to clinical medicine, rotating through a broad variety of specialties. The year is endlessly exciting and full of firsts: the first patient you interview, the first time you suture in the operating room, the first time a patient looks to you for answers, and the first time you connect with patients facing illness and death. For all its excitement, the clinical trunk is also very demanding. The sheer volume of information students are asked to learn, as well as the constant evaluation and feedback from residents and faculty on what needs to improve, can make it difficult to remember why you are there: to learn to take care of others.
We found that the best way to stay in touch with this larger goal was to spend time getting to know our patients. Listening to people tell of their lives outside of the hospital and the things that are important to them, we were able to briefly step away from the duties of learning medicine and re-connect with what brought us to this field to begin with. Hearing Mr. M’s story clarified why he was distrustful toward clinicians and brought to light a side of him that his wife knew well, but we never got to see.
At the end of the clinical trunk, we learned that others had also found the value in patients’ stories of their lives away from healthcare. We were introduced to the My Life, My Story program at the Ann Arbor VA Hospital. Through this program, UMMS students have the opportunity to talk with veterans admitted to the hospital about the important stories in their lives. Veterans can tell about their childhood, their time in the service, their hobbies, families, and memories. Students take what they learn in this conversation and write a short essay, which is added to the patient’s medical record, where the rest of the treatment team can go to learn about their patient as a person.
My Life, My Story is an opportunity for students to reconnect with the values that brought us to medicine. It provides experience in deep listening, empathy, and making sense of stories through the process of writing. We have found it to be a powerful antidote for what can sometimes be a tedious day to day during the clinical trunk, and one of the most personally rewarding aspects of medical school.
The name and details of the patient in this story were changed to make the individual unrecognizable.
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Noah Mathis (far right) is a fourth-year medical student at UMMS, and is currently taking a leave of absence to complete a research program at Memorial Sloan Kettering Cancer Center. He is interested in internal medicine and in improving care for patients at the end of life, and in his free time enjoys playing volleyball, hiking, and listening to music.
Maria Santos (far left) is a fourth-year medical student applying into Family Medicine this fall. Her interests included health equity, policy, and advocacy. In her spare time, she likes to spend time outdoors hiking, camping, and kayaking.